Active NPI
Michael Blake Davis, LPC
- Professional Counselor
- Mesquite, TX
National Provider Identifier
1609422609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 61946
- Practice address
- 2849 Nighthawk Dr
Mesquite, TX 75181-4966 - Phone
- (214) 587-5789
- Fax
- (972) 222-0520
- NPI assigned
- Aug 15, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 61946 | TX | |
| Mental Health Counselor | 101YM0800X | 61946 | TX | |
| Professional Counselor | 101YP2500X | 61946 | TX | Primary |
Addresses
Primary practice location
2849 Nighthawk Dr
Mesquite, TX 75181-4966
Mailing address
2849 Nighthawk Dr
Mesquite, TX 75181-4966
Phone (214) 587-5789
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61946 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565827200000",
"number": "1609422609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2849 NIGHTHAWK DR",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751814966",
"telephone_number": "214-587-5789",
"fax_number": "972-222-0520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2849 NIGHTHAWK DR",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751814966",
"telephone_number": "214-587-5789",
"fax_number": "972-222-0520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHAEL",
"middle_name": "BLAKE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-08-15",
"last_updated": "2019-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "61946",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "61946",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "61946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.