Individual provider Active NPI

Michele Elizabeth Davis, MS, CACD, LPC

  • Professional Counselor
  • Clarks Summit, PA
National Provider Identifier
1710280375
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC005633 Issued in PA
Practice address
301 W Grove St
Suite 11
Clarks Summit, PA 18411-2090
Phone
(570) 561-7385
Fax
(570) 309-0497
NPI assigned
Dec 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC005633 PA Primary

Addresses

Primary practice location

301 W Grove St
Suite 11
Clarks Summit, PA 18411-2090

Mailing address

301 W Grove St
Suite 11
Clarks Summit, PA 18411-2090
Phone (570) 561-7385

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PC005633PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1710280375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W GROVE ST",
            "address_2": "SUITE 11",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112090",
            "telephone_number": "570-561-7385",
            "fax_number": "570-309-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W GROVE ST",
            "address_2": "SUITE 11",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184112090",
            "telephone_number": "570-561-7385",
            "fax_number": "570-309-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHELE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MS, CACD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC005633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.