Michala Chandler Washburn Davis, LCSWA, LCASR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

144 William Ellis Dr
Advance, NC 27006-7990

Phone

(336) 998-2007

NPI assigned

Jul 17, 2020

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdavis353588@direct.ochin.org

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.

• Gaston Family Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Advance, NC
  • NPI 1245842178
  NPD
• Gaston Family Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Gastonia, NC
  • NPI 1306644315
  NPD (past)

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1245848043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 WILLIAM ELLIS DR",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270067990",
            "telephone_number": "336-998-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHBURN DAVIS",
        "first_name": "MICHALA",
        "middle_name": "CHANDLER",
        "credential": "LCSWA, LCASR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Walnut Ridge Therapy
• Taylor Walton
• War Eagle Rehabilitative Services Inc
• Lesley Lambert Weidert, D.D.S.
• Well Care Home Health of the Triad
• Well Care Home Health of the Triad, Inc
• Well Care Hospice, Inc
• Wellness Counseling PLLC

• All providers in Advance, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.

Verify at the official NPI Registry.