Nina Michele Davis, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4997 Issued in NC

Practice address

4804 Stowe Derby Dr
Charlotte, NC 28278-7342

Phone

(704) 999-7588

Fax

(704) 971-2046

NPI assigned

May 20, 2010

Last updated

Sep 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Nina Michele Gonzalez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Therapeutic Community Connections, PLLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1801115563
  NPD (past)

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1386963049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 STOWE DERBY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787342",
            "telephone_number": "704-999-7588",
            "fax_number": "704-971-2046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 STOWE DERBY DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787342",
            "telephone_number": "704-999-7588",
            "fax_number": "704-971-2046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NINA",
        "middle_name": "MICHELE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "4997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NINA",
            "last_name": "GONZALEZ",
            "middle_name": "MICHELE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Micheal Davis
• Michelle Davis, LCSW
• Natalie Davis
• Nattia Davis, MS
• Nicolette Threatt Davis, PA
• Ogechi Oduah Davis, MD
• Olen Ben Davis, DDS
• Paige Parris Davis, CRNA
• Quentin Lamont Davis
• Rachel Davis, MSW, LCSWA

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.