Amani Davis
Individual provider Active NPI Psychologist · Charlotte, NC
NPI 1548874241 · NPPES record last updated Nov 4, 2024
Key facts
- NPI
- 1548874241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 6681 (NC)
- Practice address
- 10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513 - Phone
- (704) 360-3637
- NPI assigned
- Sep 1, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Integrative Wellness Solutions PLLC
Practice addresses (Care Compare)
1942 E 7TH St
Suite 220
Charlotte, NC 28204-2418
Phone (704) 360-3637
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- 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 |
|---|---|---|---|---|
| I20250117003383 | NC | Practitioner - Clinical Psychologist | 5193254233 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6681 | NC | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrative Wellness Solutions, PLLC | Mental Health | Current |
Accepting new patients |
Locations
1942 E 7th St
Ste 220
Charlotte, NC 28204
Phone (704) 777-0693
10430 Harris Oak Blvd
Ste L
Charlotte, NC 28269
Phone (704) 317-2930
3625 N Elm St
Ste 130
Greensboro, NC 27455
122 Gateway Blvd
Ste C
Mooresville, NC 28117
Phone (980) 766-1030
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Psychologist | 103T00000X | 6681 | NC | Yes |
Addresses
Primary practice location
10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513
Mailing address
17746 Oak Park Ave
Tinley Park, IL 60477-3936
Phone (708) 444-1012
Other practice location 1
19530 Kedzie Ave
Flossmoor, IL 60422-1778
Phone (708) 799-2200
Other providers in Charlotte, NC
- Alejandra Davis
- Alexandra Davis
- Alexis Davis
- Alicia Boldt Davis
- Amanda Lanay Davis
- Amy Pritchard Davis
- Anaya Denise Davis
- Angela Davis
- Angela Catherine Davis
- Antuan Deon Davis
All providers in Charlotte, NC · Psychologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2024. 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.