Active NPI
Stephen Cole Davis, M.A., LPCC
- Mental Health Counselor
- Columbus, OH
National Provider Identifier
1366790396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- E.1200424
- Practice address
- 929 Harrison Ave
#304
Columbus, OH 43215-1346 - Phone
- (614) 940-4868
- Fax
- (614) 923-7525
- NPI assigned
- Aug 23, 2012
- Last updated
- Oct 1, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | E.1200424 | OH | Primary |
| Mental Health Counselor | 101YM0800X | C.1200424 | OH |
Addresses
Primary practice location
929 Harrison Ave
#304
Columbus, OH 43215-1346
Mailing address
929 Harrison Ave
#304
Columbus, OH 43215-1346
Phone (614) 940-4868
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.1200424 | OH | MD | Mental Health Counselor |
| E.1200424 | OH | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enliven Resources, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443657600000",
"number": "1366790396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "929 HARRISON AVE",
"address_2": "#304",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432151346",
"telephone_number": "614-940-4868",
"fax_number": "614-923-7525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 HARRISON AVE",
"address_2": "#304",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432151346",
"telephone_number": "614-940-4868",
"fax_number": "614-923-7525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "STEPHEN",
"middle_name": "COLE",
"name_prefix": "Mr.",
"credential": "M.A., LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-23",
"last_updated": "2015-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "E.1200424",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "C.1200424",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.