Individual provider Active NPI

Shannon Garlock Davis, MA, LPC

  • Professional Counselor
  • Pawley's Island, SC
National Provider Identifier
1063985968
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4574 Issued in SC
Practice address
14323 Ocean Hwy Unit 4103
Pawleys Island, SC 29585-4817
Phone
(843) 602-0884
NPI assigned
Jan 3, 2019
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 4574 SC
Mental Health Counselor 101YM0800X 4574 SC
Professional Counselor 101YP2500X 4574 SC Primary

Addresses

Primary practice location

14323 Ocean Hwy Unit 4103
Pawleys Island, SC 29585-4817

Mailing address

114 Lake TRL
Pawleys Island, SC 29585-7211
Phone (843) 602-0884

Other practice location 1

103 Queen St Ste D
Georgetown, SC 29440-3633
Phone (843) 602-0884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250417000609 SC Practitioner - Mental Health Counselor 6800311317 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4574SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Davis Licensed Professional Counseling Professional CurrentSince Feb 25, 2025 Accepting new patients
Es Pediatric Partners LLC Past Accepting new patients

Locations

103 Queen St
Ste D
Georgetown, SC 29440
Phone (843) 602-0884

14323 Ocean Hwy
Unit 4103
Pawleys Island, SC 29585
Phone (843) 310-4650

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1546473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1063985968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 LAKE TRL",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857211",
            "telephone_number": "843-602-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14323 OCEAN HWY UNIT 4103",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295854817",
            "telephone_number": "843-602-0884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Queen St Ste D",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403633",
            "country_code": "US",
            "telephone_number": "843-602-0884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHANNON",
        "middle_name": "GARLOCK",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-03",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "4574",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "4574",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "4574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawley's Island, SC

Sources for this page

Verify at the official NPI Registry.