Active NPI
Michelle Davis, PHD
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1730769175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 39857
- Practice address
- 1401 Lavaca St # 1259
Austin, TX 78701-1634 - Phone
- (831) 288-3460
- NPI assigned
- Apr 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 32514 | CA | |
| Clinical Psychologist | 103TC0700X | 39857 | TX | Primary |
Addresses
Primary practice location
1401 Lavaca St # 1259
Austin, TX 78701-1634
Mailing address
1401 Lavaca St # 1259
Austin, TX 78701-1634
Phone (831) 288-3460
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32514 | CA | MD | Clinical Psychologist |
| 39857 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687564800000",
"number": "1730769175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 LAVACA ST # 1259",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011634",
"telephone_number": "831-288-3460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 LAVACA ST # 1259",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011634",
"telephone_number": "831-288-3460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHELLE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-09",
"last_updated": "2023-06-24",
"certification_date": "2023-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32514",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "39857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.