Individual provider Active NPI

Maria M Davidian, APRN, BC

  • Mental Health Counselor
  • Aiken, SC
National Provider Identifier
1174698633
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1397 Issued in SC
Practice address
1310 Pine Log Rd
Suite a
Aiken, SC 29803-7890
Phone
(803) 649-1866
Fax
(803) 649-1868
NPI assigned
Nov 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1397 SC Primary

Addresses

Primary practice location

1310 Pine Log Rd
Suite a
Aiken, SC 29803-7890

Mailing address

1310 Pine Log Rd
Suite a
Aiken, SC 29803-7890
Phone (803) 649-1866

Other identifiers 1

IdentifierTypeStateIssuer
GP0853MedicaidSC

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1397SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Behavioral Medicine Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174698633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 PINE LOG RD",
            "address_2": "SUITE A",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037890",
            "telephone_number": "803-649-1866",
            "fax_number": "803-649-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 PINE LOG RD",
            "address_2": "SUITE A",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298037890",
            "telephone_number": "803-649-1866",
            "fax_number": "803-649-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDIAN",
        "first_name": "MARIA",
        "middle_name": "M",
        "credential": "APRN, BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "1397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0853",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.