Active NPI
Susan M. Davis, L.A.C.
- Addiction (Substance Use Disorder) Counselor
- Rolla, ND
National Provider Identifier
1629224829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1382
- Practice address
- 113 Main Ave E
Rolla, ND 58367 - Phone
- (701) 477-8272
- Fax
- (701) 477-8281
- NPI assigned
- Aug 7, 2008
- Last updated
- Aug 7, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1382 | ND | Primary |
Addresses
Primary practice location
113 Main Ave E
Rolla, ND 58367
Mailing address
PO Box 650
Devils Lake, ND 58301-0650
Phone (701) 477-8272
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 |
|---|---|---|---|
| 1382 | ND | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218067200000",
"number": "1629224829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 650",
"city": "DEVILS LAKE",
"state": "ND",
"postal_code": "583010650",
"telephone_number": "701-477-8272",
"fax_number": "701-477-8281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 MAIN AVE E",
"city": "ROLLA",
"state": "ND",
"postal_code": "58367",
"telephone_number": "701-477-8272",
"fax_number": "701-477-8281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SUSAN",
"middle_name": "M.",
"credential": "L.A.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-07",
"last_updated": "2008-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "ND",
"license": "1382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rolla, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.