Active NPI
Lacresha Marsha Davis, MS,MSCM,LPC,LCAS,NCC
- Mental Health Counselor
- Raleigh, NC
National Provider Identifier
1740308782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10002
- Practice address
- 3419 Mackinac Island LN
Raleigh, NC 27610-6915 - Phone
- (919) 280-9787
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3457 | NC | |
| Mental Health Counselor | 101YM0800X | 10002 | NC | Primary |
Addresses
Primary practice location
3419 Mackinac Island LN
Raleigh, NC 27610-6915
Mailing address
3419 Mackinac Island LN
Raleigh, NC 27610-6915
Phone (919) 280-9787
Other practice location 1
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marvin Behavioral Health Ma PC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1740308782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3419 MACKINAC ISLAND LN",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276106915",
"telephone_number": "919-280-9787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3419 MACKINAC ISLAND LN",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276106915",
"telephone_number": "919-280-9787"
}
],
"practiceLocations": [
{
"address_1": "3000 New Bern Ave",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276101231",
"country_code": "US",
"telephone_number": "919-350-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "LACRESHA",
"middle_name": "MARSHA",
"name_prefix": "Mrs.",
"credential": "MS,MSCM,LPC,LCAS,NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "3457",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "10002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.