Active NPI
Sally Davis, L.P.C., L.C.D.C.
- Mental Health Counselor
- Lubbock, TX
National Provider Identifier
1104415058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 85875
- Practice address
- 2515 80TH St
Lubbock, TX 79423-2217 - Phone
- (575) 291-9320
- NPI assigned
- Jan 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 85875 | TX | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15025 | TX |
Addresses
Primary practice location
2515 80TH St
Lubbock, TX 79423-2217
Mailing address
2515 80TH St
Lubbock, TX 79423-2217
Phone (575) 291-9320
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
| License | State | Type | Specialty |
|---|---|---|---|
| 85875 | TX | MD | Registered Dietitian |
| 15025 | TX | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1104415058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2515 80TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794232217",
"telephone_number": "575-291-9320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2515 80TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794232217",
"telephone_number": "575-291-9320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SALLY",
"credential": "L.P.C., L.C.D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-14",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "85875",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "15025",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.