Alyssa Davidson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L16250 Issued in OR

Practice address

545 W Umpqua St
Roseburg, OR 97471-2979

Phone

(541) 450-9425

Fax

(541) 900-1507

NPI assigned

Jun 22, 2021

Last updated

Jun 5, 2025By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wandering Minds Counseling & Consulting, LLC

  • Clinical Social Worker
  • Roseburg, OR
  • NPI 1194688556
  NPD Authorized official
• Juniper Tree Counseling, LLC

  • Mental Health Counselor
  • Roseburg, OR
  • NPI 1679177612
  NPD (past)

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1487223517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 W UMPQUA ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712979",
            "telephone_number": "541-900-1506",
            "fax_number": "541-900-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W UMPQUA ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712979",
            "telephone_number": "541-450-9425",
            "fax_number": "541-900-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ALYSSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L16250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel R Daven, MD
• Conor Lee Davenport, DO
• David E Owens MD PC
• David H White DMD LLC (Hucrest Family and Implant Dentistry)
• David S. Weingarten, M.D., PC
• Peter James Davidson, MD
• Adam David Davis, DMD
• Amy A Davis
• Andrea L Davis, CHW
• Charlene Davis, PMHNP

• Clinical Social Worker in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.