Miracle Davis, LCSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P021282 Issued in NC

Practice address

2747 Sunset Ave Ste 109
Rocky Mount, NC 27804-3751

Phone

(252) 985-3216

NPI assigned

Feb 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Progressive Care Services Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Rocky Mount, NC
  • NPI 1760620520
  NPD

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1629518360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2747 SUNSET AVE STE 109",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043751",
            "telephone_number": "252-985-3216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 SUNSET AVE STE 109",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043751",
            "telephone_number": "252-985-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MIRACLE",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P021282",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Samantha Davenport
• Andrea Davis, FNP-BC
• Barbara Judy Davis, LPC
• Gloria Fenner Davis, LPC
• Jade Davis, WHNP
• Renee Davis
• Rita-Kay Mabine Davis, M.D.
• Sharon Davis
• Enoch Dawson
• Day One Supportive Services

• Clinical Social Worker in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.