Active NPI
Michelle Davis, LPC
- Professional Counselor
- Texarkana, AR
National Provider Identifier
1053789263
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Dec 20, 2020.
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- P1802016
- Practice address
- 4323 Jefferson Ave
Texarkana, AR 71854-1515 - Phone
- (870) 773-0700
- NPI assigned
- Sep 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Professional Counselor | 101YP2500X | P1802016 | AR | Primary |
Addresses
Primary practice location
4323 Jefferson Ave
Texarkana, AR 71854-1515
Mailing address
505 W Grand Ave
Hot Springs, AR 71901-3931
Phone (501) 623-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 225255795 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P1802016 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1053789263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 W GRAND AVE",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719013931",
"telephone_number": "501-623-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4323 JEFFERSON AVE",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718541515",
"telephone_number": "870-773-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHELLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-03",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "P1802016",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "225255795",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, AR
- Darnell Brown Community Development Corporation
- Chelsie Davenport
- David Ashley MD DMD Oral Surgery Group, a Professional Dental Corp
- Jon William Davis, R.N.
- Kimble Dynetta Davis, LCPC
- Sharon Ann Davis, BAAS, MS
- Lashonna Faith Dawnta-Cooper
- Perri Dawson I, RCIS, RT, (R)(CI)ARR
- Robert M Day, MHPP
- Dayspring Services of Arkansas LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.