Angelina Davis

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

306909 Issued in MN

Practice address

799 Holley Ave
Saint Paul Park, MN 55071-1415

Phone

(612) 503-2814

NPI assigned

Jan 8, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1700743978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 HOLLEY AVE",
            "city": "SAINT PAUL PARK",
            "state": "MN",
            "postal_code": "550711415",
            "telephone_number": "612-503-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 HOLLEY AVE",
            "city": "SAINT PAUL PARK",
            "state": "MN",
            "postal_code": "550711415",
            "telephone_number": "612-503-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANGELINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "306909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Erica Anne Buck, SLP
• Nicole Davis, MSW, LICSW, LADC
• Nikki Donnella Divirgilio, MSW, LGSW
• Dustin Dukart, D.C.
• Alissa Eischens, LICSW
• Jill Ellingson, MA, LMFT

• Addiction (Substance Use Disorder) Counselor in St Paul Park, MN
• Providers in St Paul Park, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.