Active NPI
Stacy Davis
- Mental Health Counselor
- Rockwall, TX
National Provider Identifier
1346003308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 90342
- Practice address
- 1101 Ridge Rd Ste 132
Rockwall, TX 75087-4342 - Phone
- (214) 228-5284
- NPI assigned
- Feb 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 90342 | TX | Primary |
Addresses
Primary practice location
1101 Ridge Rd Ste 132
Rockwall, TX 75087-4342
Mailing address
512 Benjamin St
Sulphur Springs, TX 75482-3700
Phone (214) 228-5284
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
| License | State | Type | Specialty |
|---|---|---|---|
| 90342 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706832000000",
"number": "1346003308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 BENJAMIN ST",
"city": "SULPHUR SPRINGS",
"state": "TX",
"postal_code": "754823700",
"telephone_number": "214-228-5284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 RIDGE RD STE 132",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750874342",
"telephone_number": "214-228-5284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "STACY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-02",
"last_updated": "2024-02-02",
"certification_date": "2024-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "90342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.