Mary Davis, PHD PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY-275 Issued in ID

Legal business name

MARY DAVIS, PHD PLLC

Practice address

1221 W Hays St
Boise, ID 83702-5316

Phone

(208) 345-7358

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Mary Davis, PHDNPI 1912948563

Title

Psychologist

Phone

(208) 345-7358

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary A Davis, PHD

  • Counseling Psychologist
  • Boise, ID
  • NPI 1912948563

  ID

  Medicare reassignment NPD Authorized official
• Steven Thomas Brown, PHD

  • Clinical Psychologist
  • Boise, ID
  • NPI 1306930896
  NPD (past)
• Janelle Ruth Eckhardt, PHD

  • Clinical Psychologist
  • Boise, ID
  • NPI 1407900772
  NPD (past)
• Deborah K Every, PSY.D.

  • Psychologist
  • Boise, ID
  • NPI 1972639888
  NPD (past)
• Sheila Matthews, PHD

  • Clinical Psychologist
  • Boise, ID
  • NPI 1073668992
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366466021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W HAYS ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025316",
            "telephone_number": "208-345-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W HAYS ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837025316",
            "telephone_number": "208-345-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY DAVIS, PHD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "208-345-7358",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "ID",
            "license": "PSY-275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronae Martinez
• Stacey Ann Martinez, LCPC
• Stephen C Martinez, MD
• Laura Elizabeth Marx, MS
• Steven V Marx, M.D.
• Mary E River MD PA
• Mary Lynn Young, MD PLLC
• Enock Masengesho
• Autumn Rose Mason, AGACNP-BC
• Barbara J Mason, PHARM D

• All providers in Boise, ID
• Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.