Active NPI
Shameka Latoya Davis, BS MA LCAS-A
- Addiction (Substance Use Disorder) Counselor
- Knightdale, NC
National Provider Identifier
1235560772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 3458-A
- Practice address
- 7417 Knightdale Blvd Unit 101
Knightdale, NC 27545 - Phone
- (919) 261-8566
- Fax
- (919) 261-8569
- NPI assigned
- Dec 10, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3458-A | NC | Primary |
| Mental Health Counselor | 101YM0800X | NC |
Addresses
Primary practice location
7417 Knightdale Blvd Unit 101
Knightdale, NC 27545
Mailing address
7417 Knightdale Blvd Unit 101
Knightdale, NC 27545
Phone (919) 261-8566
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
- Credentials
- Bachelor of Science, Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3458-A | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Bruson Group, Inc. | Mental Health | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Raleigh, NC
- NPI 1407273733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386633600000",
"number": "1235560772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7417 KNIGHTDALE BLVD UNIT 101",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "27545",
"telephone_number": "919-261-8566",
"fax_number": "919-261-8569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7417 KNIGHTDALE BLVD UNIT 101",
"city": "KNIGHTDALE",
"state": "NC",
"postal_code": "27545",
"telephone_number": "919-261-8566",
"fax_number": "919-261-8569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SHAMEKA",
"middle_name": "LATOYA",
"credential": "BS MA LCAS-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-10",
"last_updated": "2013-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "3458-A",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knightdale, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.