Active NPI
Shannon Davis
- Mental Health Counselor
- Benton, AR
National Provider Identifier
1174254999
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 7041 Rolling Meadow Loop
Benton, AR 72015-8401 - Phone
- (501) 722-3362
- NPI assigned
- Jun 22, 2022
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
7041 Rolling Meadow Loop
Benton, AR 72015-8401
Mailing address
7041 Rolling Meadow Loop
Benton, AR 72015-8401
Phone (501) 722-3362
Other practice location 1
211 S Market
Benton, AR 72015-4303
Phone (501) 722-3362
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | shannon.davis@arkansasfamilies.org | Direct | |
| Other URL | shannondavisllc@protonmail.com |
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": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1174254999",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7041 ROLLING MEADOW LOOP",
"city": "BENTON",
"state": "AR",
"postal_code": "720158401",
"telephone_number": "501-722-3362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7041 ROLLING MEADOW LOOP",
"city": "BENTON",
"state": "AR",
"postal_code": "720158401",
"telephone_number": "501-722-3362"
}
],
"practiceLocations": [
{
"address_1": "211 S Market",
"address_purpose": "LOCATION",
"city": "Benton",
"state": "AR",
"postal_code": "720154303",
"country_code": "US",
"telephone_number": "501-722-3362",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "SHANNON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "shannon.davis@arkansasfamilies.org",
"affiliation": "N",
"endpointDescription": "business email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "211 S Market",
"city": "Benton",
"state": "AR",
"country_code": "US",
"postal_code": "720154303",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "shannondavisllc@protonmail.com",
"affiliation": "N",
"endpointDescription": "business email",
"address_1": "211 S Market",
"city": "Benton",
"state": "AR",
"country_code": "US",
"postal_code": "720154303",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Benton, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.