Caitlin Park-Davidson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC011666 Issued in PA

Practice address

4865 Market St
Philadelphia, PA 19139-3508

Phone

(610) 551-3163

NPI assigned

Aug 27, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1881779866
  Medicare reassignment NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1467776989
  NPD

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1316595069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 POTTER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341922",
            "telephone_number": "574-377-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4865 MARKET ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393508",
            "telephone_number": "610-551-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK-DAVIDSON",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC011666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria L Parisi
• Park Dental Associates P.C.
• Park Heights Dental Associates, P.C.
• Park Pleasant, Inc
• Park Prescriptions, Inc.
• Albert Park, DPT
• Alice Soo Park, NP
• Angelina Park
• Chan H Park, MD
• Chantel Park

• Professional Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.