Charles Nelson Davis, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

5891951-3904 Issued in UT

Practice address

1730 E 3100 N Ste 2
Layton, UT 84040-2408

Phone

(801) 643-1652

Fax

(801) 779-7808

NPI assigned

Apr 16, 2007

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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 Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Weber Human Services

  • Professional Counselor
  • Ogden, UT
  • NPI 1437213378
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1689899502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 E 3100 N STE 2",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840402408",
            "telephone_number": "801-643-1652",
            "fax_number": "801-779-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E 3100 N STE 2",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840402408",
            "telephone_number": "801-643-1652",
            "fax_number": "801-779-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHARLES",
        "middle_name": "NELSON",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "5891951-3904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876000308007",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "260022408",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Davis Hospital Holdings, Inc.
• Davis Hospital Holdings, Inc.
• Davis Pharmacy Inc (Davis Pharmacy)
• Davis Surgical Center, LLC
• April Davis
• Christopher L Davis, DO
• Emma Davis
• Gavin James Davis
• Michael Davis
• Molly Davis

• Marriage & Family Therapist in Layton, UT
• Providers in Layton, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.