Demarcus C Davis, LPC-MHSP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2127 Issued in TN

Practice address

1088 Rogers Rd
Cordova, TN 38018-8546

Phone

(901) 359-8330

Fax

(901) 757-4212

NPI assigned

Feb 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1619019007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 NICHOLAS CV",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381343894",
            "telephone_number": "901-359-8330",
            "fax_number": "901-757-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 ROGERS RD",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380188546",
            "telephone_number": "901-359-8330",
            "fax_number": "901-757-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEMARCUS",
        "middle_name": "C",
        "credential": "LPC-MHSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "2127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11993318",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520532",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael W Davidson, PH.D.
• Angelia Davis-Webster
• Cameron Gabrielle Davis
• Candace Marie Davis, MSW
• Chasidy Ann Davis
• Gabrielle Davis
• Glenise Aaronee Davis
• Lee Ann Davis, PHARM D
• Lela Davis
• Matthew Jonathon Davis, M.D.

• Mental Health Counselor in Cordova, TN
• Providers in Cordova, TN by specialty
• Mental Health Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.