Active NPI
Charme S. Davidson, PH.D., ABPP
- Marriage & Family Therapist
- Minneapolis, MN
National Provider Identifier
1285687889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT0245
- Practice address
- 1409 Willow St
Suite 220
Minneapolis, MN 55403-2269 - Phone
- (612) 870-0510
- Fax
- (612) 870-4542
- NPI assigned
- May 18, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP2642 | MN | |
| Marriage & Family Therapist | 106H00000X | MFT0245 | MN | Primary |
Addresses
Primary practice location
1409 Willow St
Suite 220
Minneapolis, MN 55403-2269
Mailing address
5401 Pleasant Ave
Minneapolis, MN 55419-1846
Phone (612) 825-2868
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6275478000 | Medicaid | MN | |
| LP2642 | Other | MN | MN PSYCHOLOGY LICENSE # |
| 0245 | Other | MN | MN MARRIAGE & FAM LIC # |
| 3962 | Other | MN | ABPP # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1978
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
475 Cleveland Ave N
Suite 200
Saint Paul, MN 55104-5053
Phone (612) 870-0510
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP2642 | MN | MD | Psychologist |
| MFT0245 | MN | MD | Marriage & Family Therapist |
| 2642 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charme S. Davidson, LLC | Psychologist | Current | Accepting new patients |
Locations
1409 Willow St
Ste 220
Minneapolis, MN 55403
Phone (612) 870-0216
475 Cleveland Ave N
Ste 200
Saint Paul, MN 55104
Phone (612) 802-9164
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.
-
- Psychologist
- Minneapolis, MN
- NPI 1588748982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1285687889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 PLEASANT AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554191846",
"telephone_number": "612-825-2868",
"fax_number": "612-870-4542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1409 WILLOW ST",
"address_2": "SUITE 220",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554032269",
"telephone_number": "612-870-0510",
"fax_number": "612-870-4542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "CHARME",
"middle_name": "S.",
"credential": "PH.D., ABPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP2642",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MN",
"license": "MFT0245",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6275478000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN PSYCHOLOGY LICENSE #",
"identifier": "LP2642",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MN MARRIAGE & FAM LIC #",
"identifier": "0245",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ABPP #",
"identifier": "3962",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.