Individual provider Active NPI

William Augusta Davis Jr., LHMC, LPC, LCDC, MAC

  • Mental Health Counselor
  • Fort Sam Houston, TX
National Provider Identifier
1093892515
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH 60024561 Issued in WA
Practice address
Behavioral Health Medicine-Multi-D Clinic
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234-4504
Phone
(210) 808-6460
Fax
(210) 539-9400
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 75551 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 156855 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 9787 TX
Professional Counselor 101YP2500X 178.002744 IL
Mental Health Counselor 101YM0800X LH 60024561 WA Primary

Addresses

Primary practice location

Behavioral Health Medicine-Multi-D Clinic
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234-4504

Mailing address

Behavioral Health Medicine-Multi-D Clinic, Bamc
4178 Petroleum Drive, BLDG 3528R
Fort Sam Houston, TX 78234
Phone (210) 916-4242

Other practice location 1

Brooke Army Medical Center, 7 West, RTF Clinic
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234
Phone (210) 539-9819

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

State licenses

LicenseStateTypeSpecialty
75551NCMDCounselor
156855NCMDAddiction (Substance Use Disorder) Counselor
9787TXMDAddiction (Substance Use Disorder) Counselor
LH 60024561WAMDMental Health Counselor
178.002744ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1093892515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL HEALTH MEDICINE-MULTI-D CLINIC, BAMC",
            "address_2": "4178 PETROLEUM DRIVE, BLDG 3528R",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-4242",
            "fax_number": "210-539-5467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BEHAVIORAL HEALTH MEDICINE-MULTI-D CLINIC",
            "address_2": "3551 ROGER BROOKE DRIVE",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-808-6460",
            "fax_number": "210-539-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Brooke Army Medical Center, 7 West, RTF Clinic",
            "address_2": "3551 Roger Brooke Drive",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "78234",
            "country_code": "US",
            "telephone_number": "210-539-9819",
            "fax_number": "210-916-7909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "AUGUSTA",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LHMC, LPC, LCDC, MAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-02-05",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "75551",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "156855",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "9787",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.002744",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH 60024561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.