Active NPI
Brian Earl Davis, M.DIV., PH.D.
- Professional Counselor
- Albuquerque, NM
National Provider Identifier
1760568620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CCMH0150051
- Practice address
- 8600 Academy Rd NE
Albuquerque, NM 87111-1107 - Phone
- (505) 821-3628
- NPI assigned
- Oct 31, 2006
- Last updated
- Sep 28, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | CCMH0150051 | NM | Primary |
Addresses
Primary practice location
8600 Academy Rd NE
Albuquerque, NM 87111-1107
Mailing address
8600 Academy Rd NE
Albuquerque, NM 87111-1107
Phone (505) 821-3628
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
8600 Academy Rd NE
Albuquerque, NM 87111-1107
Phone (505) 821-3628
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Formation Counseling Services Inc | Current | Accepting new patients |
Locations
8600 Academy Rd NE
Albuquerque, NM 87111
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Albuquerque, NM
- NPI 1033274535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538092800000",
"number": "1760568620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8600 ACADEMY RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871111107",
"telephone_number": "505-821-3628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8600 ACADEMY RD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871111107",
"telephone_number": "505-821-3628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BRIAN",
"middle_name": "EARL",
"name_prefix": "Dr.",
"credential": "M.DIV., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2018-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NM",
"license": "CCMH0150051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.