Individual provider Active NPI

Davisha Camille Scudder

  • Counselor
  • Yonkers, NY
National Provider Identifier
1285202341
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
11085 Issued in FL
Practice address
220 Rumsey Rd
Yonkers, NY 10705-1629
Phone
(914) 980-9303
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 11085 FL Primary

Addresses

Primary practice location

220 Rumsey Rd
Yonkers, NY 10705-1629

Mailing address

220 Rumsey Rd
Yonkers, NY 10705-1629
Phone (914) 980-9303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20240306004291 FL Practitioner - Clinical Psychologist 7012353535 Reassigns benefits to 1 organization
I20240530004062 NY Practitioner - Clinical Psychologist 7012353535 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11085FLMDCounselor
024861NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Feb 1, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

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.

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1285202341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RUMSEY RD",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107051629",
            "telephone_number": "914-980-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RUMSEY RD",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107051629",
            "telephone_number": "914-980-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCUDDER",
        "first_name": "DAVISHA",
        "middle_name": "CAMILLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "11085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.