Active NPI
Ivery Davis
- Mental Health Counselor
- Marion, SC
National Provider Identifier
1487163572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 261QM0801X
- Practice address
- Pee Dee Mental Health, Marion Clinic
1100 S. Main St.
Marion, SC 29571-2957 - Phone
- (843) 321-5082
- Fax
- (843) 321-5082
- NPI assigned
- Sep 21, 2017
- Last updated
- Sep 21, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 261QM0801X | Primary |
Addresses
Primary practice location
Pee Dee Mental Health, Marion Clinic
1100 S. Main St.
Marion, SC 29571-2957
Mailing address
1100 S Main St
Marion, SC 29571-4914
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Carolina Dept of Mental Health Accounting Office | 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.
-
dba Midlands Crisis Stabilization Center
- Community/Behavioral Health Agency
- Columbia, SC
- NPI 1083421994
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505952000000",
"number": "1487163572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 S MAIN ST",
"city": "MARION",
"state": "SC",
"postal_code": "295714914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PEE DEE MENTAL HEALTH, MARION CLINIC",
"address_2": "1100 S. MAIN ST.",
"city": "MARION",
"state": "SC",
"postal_code": "295712957",
"telephone_number": "843-321-5082",
"fax_number": "843-321-5082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "IVERY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-21",
"last_updated": "2017-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": "261QM0801X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.