Sarah Ashley Diane Davis, LCPC
Individual provider Active NPI Professional Counselor · Lincoln, IL
NPI 1558066738 · NPPES record last updated Apr 5, 2023
Key facts
- NPI
- 1558066738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180015094 (IL)
- Practice address
- 515 N College St
Lincoln, IL 62656-1401 - Phone
- (217) 525-1064
- Fax
- (217) 525-1651
- NPI assigned
- Apr 5, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mental Health Centers of Central Illinois
Practice addresses (Care Compare)
710 N 8TH St
Springfield, IL 62702-6324
Phone (217) 525-1064
901 N 1St St
Suite 225
Springfield, IL 62702-3760
Phone (217) 788-4065
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- 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 |
|---|---|---|---|---|
| I20240212003197 | IL | Practitioner - Mental Health Counselor | 0941643415 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180015094 | IL | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Centers of Central Illinois | Current |
Accepting new patients | |
| Mental Health Centers of Central Illinois | Professional | Current |
Accepting new patients |
Locations
340 W State St
Jacksonville, IL 62650
Phone (217) 245-6126
515 N College St
Lincoln, IL 62656
Phone (217) 732-9681
901 N 1st St
Ste 225
Springfield, IL 62702
Phone (217) 523-2217
3225 Hedley Rd
Springfield, IL 62711
Phone (217) 726-6700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180015094 | IL | Yes |
Addresses
Primary practice location
515 N College St
Lincoln, IL 62656-1401
Mailing address
PO Box 3428
Springfield, IL 62708-3428
Phone (217) 525-1064
Other providers in Lincoln, IL
- Melissa L. Cox
- Cra, Inc
- Jaycee Craver
- Julie Cross
- Cassandra Dahm
- Jenna N Dean
- Donald T. Dearth
- Joyce Jane Dearth
- Jessica Ann Demarco
- Bruce Anderson Demont
All providers in Lincoln, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 5, 2023. 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.