Sherrill Taren Davis, LCDC-I 37787

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37787 Issued in TX

Practice address

4107 Acorn LN
Porter, TX 77365-9611

Phone

(281) 608-7600

Fax

(281) 608-7602

NPI assigned

Jan 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sherrill Taren Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Westbridge Recovery Center, Inc

  • Substance Abuse Rehabilitation Facility
  • Porter, TX
  • NPI 1649712951
  NPD (past)

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1134466030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4107 ACORN LN",
            "city": "PORTER",
            "state": "TX",
            "postal_code": "773659611",
            "telephone_number": "281-608-7600",
            "fax_number": "281-608-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 ACORN LN",
            "city": "PORTER",
            "state": "TX",
            "postal_code": "773659611",
            "telephone_number": "281-608-7600",
            "fax_number": "281-608-7602"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "995 Gateway Center Way",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921024500",
            "country_code": "US",
            "telephone_number": "619-398-2165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHERRILL",
        "middle_name": "TAREN",
        "name_prefix": "Mrs.",
        "credential": "LCDC-I 37787",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "37787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRILL",
            "last_name": "JACKSON",
            "middle_name": "TAREN",
            "credential": "PCCI2441",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• CVS Pharmacy Inc
• Amber Dameron
• Haley Marilyn Daniels, WHNP-BC
• Nichala L. Davidson, LPC
• Paula Jo Davis, LM
• Klara De la Garza
• Debra Anne Decato, LSA
• Andrea Danielle Dillon, COTA
• Diverse Community Healthcare PLLC
• Diverse Community Urgent Care PLLC

• Addiction (Substance Use Disorder) Counselor in Porter, TX
• Providers in Porter, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.