Organization Active NPI

Wayne E. Davidson, LMHC

  • Mental Health Counselor
  • Tampa, FL
National Provider Identifier
1154680346
Registry record updated Dec 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WAYNE E. DAVIDSON, LMHC
Practice address
14921 W Hardy Dr
Tampa, FL 33613-1546
Phone
(813) 979-0535
Fax
(813) 304-0088
NPI assigned
May 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2024

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

Authorized official

Name
Mr. Wayne Edward Davidson, LMHCNPI 1568682912
Title
President
Phone
(813) 979-0535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

14921 W Hardy Dr
Tampa, FL 33613-1546

Mailing address

14921 W Hardy Dr
Tampa, FL 33613-1546
Phone (813) 979-0535

Other identifiers 1

IdentifierTypeStateIssuer
001296600MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734825600000",
    "number": "1154680346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14921 W HARDY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131546",
            "telephone_number": "813-979-0535",
            "fax_number": "813-975-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14921 W HARDY DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131546",
            "telephone_number": "813-979-0535",
            "fax_number": "813-304-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE E. DAVIDSON, LMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2024-12-22",
        "certification_date": "2024-12-17",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-979-0535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001296600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2024; 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.