Active NPI
Beverly Mae Davis, PH.D.
- Mental Health Counselor
- San Antonio, TX
National Provider Identifier
1619085594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 23435
- Practice address
- 14919 Northern Dancer
San Antonio, TX 78248-0925 - Phone
- (210) 857-4215
- Fax
- (210) 568-2108
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 23435 | TX | Primary |
Addresses
Primary practice location
14919 Northern Dancer
San Antonio, TX 78248-0925
Mailing address
12922 Vista HVN
San Antonio, TX 78216-1703
Phone (210) 492-7855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050805000357 | TX | Practitioner - Clinical Psychologist | 0446289813 | Practice locations: San Antonio, TX |
| I20251121001277 | NM | Practitioner - Psychologist Billing Independently | 0446289813 | Practice locations: Albuquerque, NM |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
13120 Nandina LN SE
Albuquerque, NM 87123-4185
Phone (210) 857-4215
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23435 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741564800000",
"number": "1619085594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12922 VISTA HVN",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782161703",
"telephone_number": "210-492-7855",
"fax_number": "210-494-4215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14919 NORTHERN DANCER",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782480925",
"telephone_number": "210-857-4215",
"fax_number": "210-568-2108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BEVERLY",
"middle_name": "MAE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2025-03-10",
"certification_date": "2025-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "23435",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.