Charlene Davis, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

164 Waccamaw Medical Park Dr
Conway, SC 29526

Phone

(843) 347-5060

Fax

(843) 347-3959

NPI assigned

Oct 22, 2014

Last updated

Jan 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• South Carolina Dept of Mental Health Accounting Office

  dba Midlands Crisis Stabilization Center

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD (past)

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1528462355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268903",
            "telephone_number": "843-347-5060",
            "fax_number": "843-347-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WACCAMAW MEDICAL PARK DR",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "29526",
            "telephone_number": "843-347-5060",
            "fax_number": "843-347-3959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 N Guignard Dr",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291501519",
            "country_code": "US",
            "telephone_number": "803-775-7898",
            "fax_number": "803-773-5246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1175 N Guignard Dr",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291501519",
            "country_code": "US",
            "telephone_number": "803-775-7898",
            "fax_number": "803-773-5246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHARLENE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kairavee Dave, MD
• Reginald Forrest Daves, MD
• Alison Nicole Davis, MSN, APRN, FNP-C
• Austin Reece Davis, DMD
• Brittni Elizabeth Davis, FNP-BC
• Connie Rae Davis
• Naomi De Cristo, RN
• Sarah M Dean, NP
• Shayla Dearborn
• Victoria Labonte Decker, APRN

• Mental Health Counselor in Conway, SC
• Providers in Conway, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.