Brooklyn Summer Davis

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1379 Cowell Farm Rd
Washington, NC 27889-3495

Phone

(252) 975-8852

NPI assigned

Jan 10, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Inner Source Therapy, PLLC

  • Mental Health Counselor
  • New Bern, NC
  • NPI 1831867175
  NPD (past)

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1154035533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 GUM BRANCH RD APT 1021",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404596",
            "telephone_number": "252-767-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1379 COWELL FARM RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893495",
            "telephone_number": "252-975-8852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BROOKLYN",
        "middle_name": "SUMMER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-06",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Davenport, LCMHCA
• Nicole M Davia, PA-C
• David Lauren Fitzgerald OD PA
• David R Swarner MD PA
• Brenda C. Davis, LCSW
• Destiny S Davis
• George Edward Davis, MD
• Lindsay R Davis, FNP-C
• Victoria Avery Davis, FNP-C
• Christopher Pierce Deans, PA-C

• Addiction (Substance Use Disorder) Counselor in Washington, NC
• Providers in Washington, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.

Verify at the official NPI Registry.