Donald Lee Davidson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1823 Issued in GA

Practice address

620 Hillcrest Rd NW
Suite 300
Lilburn, GA 30047-1709

Phone

(770) 638-1577

Fax

(770) 638-1580

NPI assigned

Nov 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2016 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gracepoint Counseling Associates

  • Clinical Psychologist
  • Lilburn, GA
  • NPI 1487705091
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629144183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 HILLCREST RD NW",
            "address_2": "SUITE 300",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471709",
            "telephone_number": "770-638-1577",
            "fax_number": "770-638-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 HILLCREST RD NW",
            "address_2": "SUITE 300",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300471709",
            "telephone_number": "770-638-1577",
            "fax_number": "770-638-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "DONALD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00625776B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anh-Thu Dang, DMD
• Hong Dang, FNP-C
• Chenee M Daniels, RPH
• Jordan Daniels
• Aaron Davidson
• Windell C Davis-Boutte, M.D.
• Carol Dawn Davis, MD
• Jeffrey William Davis, PTA
• Richard Lee Dawson
• Yolanda DS Dawson

• Clinical Psychologist in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.