Samuel Kyle Davis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0015775 Issued in CO

Practice address

2470 Patterson Rd Ste 6Office5
Grand Junction, CO 81505-1028

Phone

(970) 433-5728

NPI assigned

Jan 19, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• First Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Junction, CO
  • NPI 1083230221
  NPD Authorized official

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1407213705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 N 26TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016290",
            "telephone_number": "970-433-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 PATTERSON RD STE 6OFFICE5",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051028",
            "telephone_number": "970-433-5728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAMUEL",
        "middle_name": "KYLE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0015775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Davis
• Meredith Davis
• Michell Lynn Davis
• Michelle Lynn Davis, PTA
• Ryan Davis
• Sandra Davis
• Toni M Davison, P.A.-C
• Nancy J Dawson, BS PHARMACY
• Tilley Dawson
• Day Surgery of Grand Junction LLC

• Professional Counselor in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.