William W Davis, PSY D CLINICAL PSYCH

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1304 Issued in OR

Practice address

2250 D St NE
Salem, OR 97301-2768

Phone

(503) 364-6093

Fax

(503) 364-5121

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mid Valley Counseling Center Inc

  • Clinical Psychologist
  • Salem, OR
  • NPI 1407039308
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1205901675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 D ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012768",
            "telephone_number": "503-364-6093",
            "fax_number": "503-364-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 D ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012768",
            "telephone_number": "503-364-6093",
            "fax_number": "503-364-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "credential": "PSY D CLINICAL PSYCH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Marie Davis, CADC II, QMHA
• Peter Christopher Davis Jr., L.C.S.W.
• Sheila Davis
• Shelley Eileen Davis, CADC I, QMHA
• Stephenie Saint Davis, LPC
• Whitney Dawkins
• Amanda Elspeth Day
• Emily Irene Day
• Jacqueline Caye Day, LMT
• John M Day, CADC II

• Clinical Psychologist in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.