Robert Davis, M.ED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0680000714 Issued in VT

Practice address

11 N Main St
Randolph, VT 05060-1126

Phone

(802) 728-4466

Fax

(802) 728-4197

NPI assigned

Aug 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Clara Martin CenterGroup PAC ID 1951395367, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

Practice roles

Locations

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.

• Clara Martin Center

  • Community/Behavioral Health Agency
  • Randolph, VT
  • NPI 1386710861
  Medicare reassignment Care Compare group NPD
• Clara Martin Center

  • Community/Behavioral Health Agency
  • Randolph, VT
  • NPI 1548060015
  NPD

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1154511459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 SUGAR PLUM CT",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050609379",
            "telephone_number": "802-728-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 N MAIN ST",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050601126",
            "telephone_number": "802-728-4466",
            "fax_number": "802-728-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "credential": "M.ED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "0680000714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2393212",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Crosby, LCMHC
• Marjorie Randall Crowe, M.S.W.
• Jeanne M Crowley, LADC
• James Byron Currie, MD
• Jennifer Davis, R.N., IBCLC
• Priscella Desjardins
• Samantha Diehl, BCBA
• Jason Dimond, BA
• Christina Ilse Dinicola, M.D.
• Louis A. Dinicola, M.D.

• Mental Health Counselor in Randolph, VT
• Providers in Randolph, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.