Lottie Grace Olson-Davidson, PH.D., LPC, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

VA #0701005309 Issued in VA

Practice address

4222 Fortuna Center PLZ Ste 192
Dumfries, VA 22025-1515

Phone

(703) 910-7529

Fax

(703) 910-7555

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Grace Counseling & Mediation Services LLC

  • Mental Health Counselor
  • Woodbridge, VA
  • NPI 1144476847
  Medicare reassignment NPD Authorized official
• Myspectrum LLC

  • Mental Health Counselor
  • North Chesterfield, VA
  • NPI 1174029359
  Medicare reassignment NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1528090016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4222 FORTUNA CENTER PLZ STE 192",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251515",
            "telephone_number": "703-910-7529",
            "fax_number": "703-910-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4222 FORTUNA CENTER PLZ STE 192",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220251515",
            "telephone_number": "703-910-7529",
            "fax_number": "703-910-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON-DAVIDSON",
        "first_name": "LOTTIE",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LPC, LCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "456",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "4402",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "C-4523",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "NC # 9490",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "PRC14303",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "9384",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC7371",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "PC7218",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "VA #0701005309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Oden
• Eva Odoom, RBT
• Chika C Okeoma, NP
• Dana Okyere
• Judith Olkaba, DPM
• Oma-Home Health Services LLC
• Nnenna Onwunmelu, RN
• Open Thoughts LLC
• Oral and Facial Surgery Center of Virginia
• Sabine Ruth Owen, PMHNP

• Mental Health Counselor in Dumfries, VA
• Providers in Dumfries, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.