T. Conswello Davis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

18391 Issued in FL

Practice address

3911 Hollywood Blvd Ste 2
Hollywood, FL 33021-6795

Phone

(954) 639-7345

NPI assigned

Jul 9, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Goddess Health & Wellness, LLC

  • Mental Health Counselor
  • Hollywood, FL
  • NPI 1043830425
  NPD

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1770135972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4223",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333384223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 HOLLYWOOD BLVD STE 2",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216795",
            "telephone_number": "954-639-7345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1033 NW 6th St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333118125",
            "country_code": "US",
            "telephone_number": "754-300-7591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "T. CONSWELLO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "18391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Conswello@milleniumclinic.com",
            "affiliation": "N",
            "address_1": "3911 Hollywood Blvd Ste 2",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330216795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "goddesshwell@gmail.com",
            "affiliation": "N",
            "address_1": "1033 NW 6th St Ste 202",
            "city": "Fort Lauderdale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333118125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina E Davis, PA-C
• Jean Davis, ARNP
• Karel J Davis
• Sheera Tzippora Davis
• Sydney Joyce Davis, PEER SPECIALIST, NOT
• Andrey Davydov, LCSW
• Casey Jennifer Dawson, PH.D.
• Natalie Dayan, M.S., CCC-SLP
• Dayclinic Inc.
• Karinna Vanessa Dazza

• Mental Health Counselor in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.