Debbie Davis, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1353 Issued in MN

Practice address

1111 Highway 73
Moose Lake, MN 55767-9452

Phone

(218) 565-6281

NPI assigned

Nov 16, 2016

Last updated

Nov 16, 2016By the provider in NPPES

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 MN

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northern Waters ClinicGroup PAC ID 1355816182, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Northern Waters Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hermantown, MN
  • NPI 1316445455
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479254400000",
    "number": "1386186708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 HIGHWAY 73",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679452",
            "telephone_number": "218-565-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 HIGHWAY 73",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679452",
            "telephone_number": "218-565-6281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEBBIE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "1353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luann Joyce Charboneau, PT
• Raymond G. Christensen, M.D.
• Heather Cronemiller, MA, LICSW
• Darci Kay Dahl, PTA
• Kimberly Mary Davidson, R.N
• Paul R. Dewey, M.D.
• Kathryn Dobbs, M.D.
• Downtown Dental Care PA
• Dr. Joseph J. Jamros Optometry, LTD.
• Steffany Drilling, MT

• Professional Counselor in Moose Lake, MN
• Providers in Moose Lake, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.