Individual provider Active NPI

Clarissa Davis

  • Professional Counselor
  • Lawrenceburg, TN
National Provider Identifier
1720596356
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3318 Issued in MS
Practice address
129 N Locust Ave
Lawrenceburg, TN 38464-3757
Phone
(931) 762-7232
NPI assigned
Jan 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH18473 FL
Mental Health Counselor 101YM0800X 21504 NC
Mental Health Counselor 101YM0800X 6801 TN
Professional Counselor 101YP2500X 3318 MS Primary

Addresses

Primary practice location

129 N Locust Ave
Lawrenceburg, TN 38464-3757

Mailing address

11373 Cocoa Beach Dr
Riverview, FL 33569-2951

Other practice location 1

1437 S Belcher Rd
Clearwater, FL 33764-2829
Phone (727) 524-4464

Other practice location 2

1635 College Ave
Spindale, NC 28160-0016
Phone (828) 330-9190

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN, KY, NC, MS5 enrollments
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.

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20240221001284 FL Practitioner - Mental Health Counselor 3274977921
I20241101000134 TN Practitioner - Mental Health Counselor 3274977921 Reassigns benefits to 2 organizations
I20241220002151 KY Practitioner - Mental Health Counselor 3274977921 Reassigns benefits to 2 organizations
I20250611002489 NC Practitioner - Mental Health Counselor 3274977921 Reassigns benefits to 2 organizations
I20250709003011 MS Practitioner - Mental Health Counselor 3274977921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, shared by 15 NPIs, 737 clinicians

Practice addresses (Care Compare)

4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH18473FLMDMental Health Counselor
21504NCMDMental Health Counselor
3318MSMDProfessional Counselor
6801TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 1, 2024 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Nov 25, 2024 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Jun 27, 2025 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Nov 25, 2024 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Sep 1, 2024 Accepting new patients
Fast Pace Mississippi, PLLC CurrentSince Jun 27, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Jun 4, 2025 Accepting new patients

Locations

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

115 Tradepark Dr
Ste A
Somerset, KY 42503
Phone (606) 678-5708

700 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2884

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206

212 S Tryon St
Ste 100
Charlotte, NC 28281

1515 Mockingbird Ln
Ste 420
Charlotte, NC 28209
Phone (310) 230-5984

1635 College Ave
Spindale, NC 28160
Phone (828) 330-9190

7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038

129 N Locust Ave
Lawrenceburg, TN 38464
Phone (855) 560-4999

Organizations & group practices 9

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": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1720596356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11373 COCOA BEACH DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335692951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 N LOCUST AVE",
            "city": "LAWRENCEBURG",
            "state": "TN",
            "postal_code": "384643757",
            "telephone_number": "931-762-7232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1437 S Belcher Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337642829",
            "country_code": "US",
            "telephone_number": "727-524-4464",
            "fax_number": "727-538-7272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1635 College Ave",
            "address_purpose": "LOCATION",
            "city": "Spindale",
            "state": "NC",
            "postal_code": "281600016",
            "country_code": "US",
            "telephone_number": "828-330-9190",
            "fax_number": "828-330-9191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CLARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18473",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "21504",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "6801",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "3318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceburg, TN

Sources for this page

Verify at the official NPI Registry.