Dazzmen Nikole Davis, LCMHC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10572 Issued in NC

Practice address

3350 Footbridge LN Ste 124
Fayetteville, NC 28306-9695

Phone

(980) 990-2642

Fax

(404) 726-4881

NPI assigned

Aug 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC, GA3 enrollments

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 3

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Backpack Medical Group, P.C.

  • Clinical Social Worker
  • Elkridge, MD
  • NPI 1851177570

  GA, Professional

  Medicare reassignment NPD
• Flowly Health Medical Group P a

  • Clinical Social Worker
  • Miami, FL
  • NPI 1235983826

  NC

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC, Professional, SC

  Medicare reassignment NPD
• Black Serene, PLLC

  • Professional Counselor
  • Fayetteville, NC
  • NPI 1184472573
  NPD Authorized official
• Daymark Recovery Services, Inc.

  • Multi-Specialty Clinic/Center
  • Concord, NC
  • NPI 1558329243
  Medicare reassignment
• Linnel Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Elkridge, MD
  • NPI 1932795044
  NPD (past)

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

{
    "created_epoch": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1184279002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 FOOTBRIDGE LN STE 124",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069695",
            "telephone_number": "980-990-2642",
            "fax_number": "404-726-4881"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Peace St",
            "address_purpose": "LOCATION",
            "city": "N Wilkesboro",
            "state": "NC",
            "postal_code": "286594519",
            "country_code": "US",
            "telephone_number": "336-667-7191",
            "fax_number": "336-667-6859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAZZMEN",
        "middle_name": "NIKOLE",
        "credential": "LCMHC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC015521",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "10572",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "LPC9824PC",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantel Davis, CSFA
• Christie L Davis, MSW,LCSW
• Christopher Davis, MD
• Danielle Davis
• Dayonna Davis
• Demetria Jacques Davis
• Elaine Davis
• Elizabeth Kristin Davis, PA-C
• Emma Carter Davis, LCMHC
• Frankie Davis

• Professional Counselor in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.