Active NPI
Mikaela Davison
- Mental Health Counselor
- Buckley, WA
National Provider Identifier
1497300651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC61528653
- Practice address
- 159 South Cedar St
Buckley, WA 98321 - Phone
- (503) 426-6335
- NPI assigned
- Aug 5, 2019
- Last updated
- Aug 23, 2024
- Sex
- Female
- Sole proprietor
- No
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 | MC61528653 | WA | Primary |
Addresses
Primary practice location
159 South Cedar St
Buckley, WA 98321
Mailing address
PO Box 762
Buckley, WA 98321-0762
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC61528653 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724371200000",
"number": "1497300651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 762",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "983210762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 SOUTH CEDAR ST",
"city": "BUCKLEY",
"state": "WA",
"postal_code": "98321",
"telephone_number": "503-426-6335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISON",
"first_name": "MIKAELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-05",
"last_updated": "2024-08-23",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC61528653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buckley, WA
- City of Buckley (City of Buckley Fire Department)
- CLB Pharmaceutical Resources Inc (CLB Healthcare Resources)
- Jennifer Cochrane-Nicolls, M.S.W.
- Clare Elizabeth Coetzer, ARNP, LICSW
- Anna Marie Corey, COTA
- Beth J. Decarteret, LMP
- Tyler Drew Delmonte
- Danette Louise Delo, DNP-PMHNP
- Judy Ann Desoto, PTA
- Joanne Elizabeth Earle, PTA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.