Individual provider Active NPI

Tamara Davison

  • Professional Counselor
  • Laurinburg, NC
National Provider Identifier
1487856159
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3789 Issued in NC
Practice address
1603 Medical Dr Ste a
Laurinburg, NC 28352-5541
Phone
(910) 276-7011
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3789 NC Primary

Addresses

Primary practice location

1603 Medical Dr Ste a
Laurinburg, NC 28352-5541

Mailing address

1603 Medical Dr Ste a
Laurinburg, NC 28352-5541
Phone (910) 276-7011

Other identifiers 1

IdentifierTypeStateIssuer
6102963MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117001809 NC Practitioner - Mental Health Counselor 6305298175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Psychological Associates PAGroup PAC ID 3678587995, 4 clinicians

Practice addresses (Care Compare)

1501 Highwoods Blvd
Suite 101
Greensboro, NC 27410-2051
Phone (336) 272-0855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3789NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Psychological Associates, P.a. CurrentSince Jan 1, 2024 Accepting new patients
Scotland Family Counseling Center, Inc. Professional Past Accepting new patients

Locations

1501 Highwoods Blvd
Ste 101
Greensboro, NC 27410
Phone (336) 272-0855

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1487856159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 MEDICAL DR STE A",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525541",
            "telephone_number": "910-276-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 MEDICAL DR STE A",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525541",
            "telephone_number": "910-276-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "TAMARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102963",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurinburg, NC

Sources for this page

Verify at the official NPI Registry.