Individual provider Active NPI

Cassandrea Davidson

  • Mental Health Counselor
  • Tulsa, OK
National Provider Identifier
1407186380
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2725 E Skelly Dr
Suite 200
Tulsa, OK 74105-6241
Phone
(918) 592-1622
Fax
(918) 392-3328
NPI assigned
Dec 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2725 E Skelly Dr
Suite 200
Tulsa, OK 74105-6241

Mailing address

1638 S Carson Ave Apt 512
Tulsa, OK 74119-4229

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

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1407186380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 S CARSON AVE APT 512",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741194229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 E SKELLY DR",
            "address_2": "SUITE 200",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741056241",
            "telephone_number": "918-592-1622",
            "fax_number": "918-392-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "CASSANDREA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.