Individual provider Active NPI

Athena J. Davis, L.P.C.

  • Professional Counselor
  • Henrico, VA
National Provider Identifier
1326306911
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701004318 Issued in VA
Practice address
5412 Glenside Dr Ste F
Henrico, VA 23228-3995
Phone
(804) 282-5880
Fax
(804) 288-2029
NPI assigned
May 2, 2012
Last updated
May 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701004318 VA Primary

Addresses

Primary practice location

5412 Glenside Dr Ste F
Henrico, VA 23228-3995

Mailing address

5412 Glenside Dr Ste F
Henrico, VA 23228-3995
Phone (804) 282-5880

Other identifiers 1

IdentifierTypeStateIssuer
1306859988MedicaidVA

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

State licenses

LicenseStateTypeSpecialty
0701004318VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1326306911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5412 GLENSIDE DR STE F",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232283995",
            "telephone_number": "804-282-5880",
            "fax_number": "804-288-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5412 GLENSIDE DR STE F",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232283995",
            "telephone_number": "804-282-5880",
            "fax_number": "804-288-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ATHENA",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701004318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306859988",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henrico, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.