Davis M Shryer III, LADC, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CC13026 Issued in MN

Practice address

195 5TH Street East
#1408
Saint Paul, MN 55101

Phone

(651) 308-5540

Fax

(763) 537-6666

NPI assigned

Apr 26, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1461628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1215382379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 5TH ST E APT 1408",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012965",
            "telephone_number": "651-308-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 5TH STREET EAST",
            "address_2": "#1408",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55101",
            "telephone_number": "651-308-5540",
            "fax_number": "763-537-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRYER",
        "first_name": "DAVIS",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "LADC, LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-26",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC13026",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302852",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Showers, LADC
• John Shrake
• Rasmita Shrestha, DNP
• Lisa A Shriver, CNP
• Sarah Shriver
• Renee Kristin Shull, LGSW, LMSW
• Sarah Shulman
• Joshua Shultz
• Pamela Jo Shultz, MD
• Handful Siaway

• Professional Counselor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.