Erin Marie Davis, PH.D., HSPP
Individual provider Active NPI Clinical Psychologist · Wabash, IN
NPI 1528544293 · NPPES record last updated Jul 16, 2018
Key facts
- NPI
- 1528544293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 20042897A (IN)
- Practice address
- 5233 S 50 E
Wabash, IN 46992-8011 - Phone
- (260) 563-1158
- Fax
- (260) 563-0318
- NPI assigned
- Jul 16, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- U S Health Dept of Health and Human Services
Practice addresses (Care Compare)
550 6TH S Ave
Wolf Point Health Center
Wolf Point, MT 59201-0000
Phone (406) 653-1641
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260115002190 | TX | Practitioner - Clinical Psychologist | 2961988332 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20042897A | IN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| U S Health Dept of Health & Human Services | Current |
Accepting new patients | |
| Teladoc Health Medical Group, P.a. | Current | Accepting new patients | |
| US Health Dept of Health & Human Services | Current |
Accepting new patients |
Locations
669 Agency Main St
Harlem, MT 59526
Phone (406) 353-3100
107 H St
Poplar, MT 59255
Phone (406) 738-3491
Interoperability endpoints
- erindavis@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20042897A | IN | Yes |
Addresses
Primary practice location
5233 S 50 E
Wabash, IN 46992-8011
Mailing address
5233 S 50 E
Wabash, IN 46992-8011
Phone (260) 563-1158
Other providers in Wabash, IN
- Eric E Dale
- Rachel Adele Dale
- Bridget M Darr
- Brian Davault
- Katie Davidson
- Daywalt Pharmacies, Inc
- Sherise L.E. Deardorff
- Gary Degrandchamp
- Brooke Derby
- Lauren Dobson
All providers in Wabash, IN · Clinical Psychologist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.