Active NPI
Lacey Davis, LPC-S
- Professional Counselor
- Oklahoma City, OK
National Provider Identifier
1174936108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7220
- Practice address
- 4800 E I 240 Service Rd Apt 1111
Oklahoma City, OK 73135-2629 - Phone
- (140) 540-1974
- NPI assigned
- Jun 6, 2014
- Last updated
- Aug 30, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7220 | OK | Primary |
Addresses
Primary practice location
4800 E I 240 Service Rd Apt 1111
Oklahoma City, OK 73135-2629
Mailing address
4800 E I 240 Service Rd Apt 1111
Oklahoma City, OK 73135-2629
Phone (140) 540-1974
Other practice location 1
1420 NE 13th St
Oklahoma City, OK 73117-2017
Phone (405) 401-9740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200551560 | Medicaid | OK |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7220 | OK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Professional | Current | Accepting new patients |
Interoperability endpoints
- laceydavis@tdh.allscriptsdirect.net
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.
-
- Family Medicine Physician
- Lewisville, TX
- NPI 1245403567
Professional
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661817600000",
"number": "1174936108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 E I 240 SERVICE RD APT 1111",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731352629",
"telephone_number": "140-540-1974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 E I 240 SERVICE RD APT 1111",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731352629",
"telephone_number": "140-540-1974"
}
],
"practiceLocations": [
{
"address_1": "1420 NE 13th St",
"address_purpose": "LOCATION",
"city": "Oklahoma City",
"state": "OK",
"postal_code": "731172017",
"country_code": "US",
"telephone_number": "405-401-9740",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "LACEY",
"credential": "LPC-S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-06",
"last_updated": "2022-08-30",
"certification_date": "2022-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "7220",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200551560",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.