Charme S. Davidson, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP2642 Issued in MN

Legal business name

CHARME S. DAVIDSON, LLC

Practice address

211 N 1St St Ste 285
Minneapolis, MN 55401-1480

Phone

(612) 870-0510

NPI assigned

Oct 24, 2006

Organization subpart

No

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

Authorized official

Name

Charme S. S. Davidson, PH.D.

Title

Sole Owner/Sole Member

Phone

(612) 870-0510

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charme S. Davidson, PH.D., ABPP

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1285687889

  Psychologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1588748982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N 1ST ST STE 285",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011480",
            "telephone_number": "612-870-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N 1ST ST STE 285",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554011480",
            "telephone_number": "612-870-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARME S. DAVIDSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "CHARME S.",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "SOLE OWNER/SOLE MEMBER",
        "authorized_official_telephone_number": "612-870-0510",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2642",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1285687889",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "627547800",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charmedavidson@charmedavidson.com",
            "affiliation": "N",
            "endpointDescription": "secure e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "patient  e-mail",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "patient correspondence",
            "address_1": "211 N 1st St Ste 285",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554011480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charmedavidson@charmedavidson.com",
            "affiliation": "N",
            "endpointDescription": "secure e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "paper correspondence",
            "address_1": "211 N 1st St Ste 285",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554011480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Joseph Charland, MS LP LMFT LICSW
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• Lawrence Richard Charnas, M.D., PHD
• Orlando Charry-Rodriquez, MD
• Elinor Florence Chase-Andresen
• Adam C. Chase, LICSW
• Lisa Maureen Chase, LICSW

• Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.