Active NPI
Carolyn Ann Davis, LPC, NCC, CCDP-D
- Professional Counselor
- Lake Charles, LA
National Provider Identifier
1104964543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3475
- Practice address
- 4105 Kirkman St
Lake Charles, LA 70607-4603 - Phone
- (337) 475-8022
- Fax
- (337) 475-8054
- NPI assigned
- Feb 1, 2007
- Last updated
- Jun 4, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3475 | LA | Primary |
Addresses
Primary practice location
4105 Kirkman St
Lake Charles, LA 70607-4603
Mailing address
3508 Rachel Dr
P.O. Box 3129
Sulphur, LA 70663-0377
Phone (337) 528-2624
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244073600000",
"number": "1104964543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3508 RACHEL DR",
"address_2": "P.O. BOX 3129",
"city": "SULPHUR",
"state": "LA",
"postal_code": "706630377",
"telephone_number": "337-528-2624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4105 KIRKMAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706074603",
"telephone_number": "337-475-8022",
"fax_number": "337-475-8054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CAROLYN",
"middle_name": "ANN",
"credential": "LPC, NCC, CCDP-D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-01",
"last_updated": "2009-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "3475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.