Individual provider Active NPI

Laquanda Tamika Davis

  • Psychiatric/Mental Health Nurse Practitioner
  • West Chester, PA
National Provider Identifier
1639970486
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP031221 Issued in PA
Practice address
1695 Lenape Rd
West Chester, PA 19382-6801
Phone
(301) 593-1315
NPI assigned
Mar 19, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP031221 PA Primary

Addresses

Primary practice location

1695 Lenape Rd
West Chester, PA 19382-6801

Mailing address

4055 Ridge Ave Apt 2502
Philadelphia, PA 19129-1581
Phone (215) 501-2636

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250429001597 PA Practitioner - Nurse Practitioner 9032635412 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychogeriatric Services LLC CurrentSince Apr 7, 2025 Accepting new patients

Locations

12073 Tech Rd
Ste B
Silver Spring, MD 20904
Phone (240) 396-5873

595 Biglerville Rd
Gettysburg, PA 17325
Phone (717) 334-6249

146 E King St
Lancaster, PA 17602
Phone (302) 990-2323

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1742342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1639970486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 RIDGE AVE APT 2502",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291581",
            "telephone_number": "215-501-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 LENAPE RD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193826801",
            "telephone_number": "301-593-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LAQUANDA",
        "middle_name": "TAMIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-19",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP031221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.