Active NPI
Stacie Davis, LPC
- Counselor
- Virginia Beach, VA
National Provider Identifier
1790860559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 0701003776
- Practice address
- 289 Independence Blvd
Suite 245
Virginia Beach, VA 23462-5493 - Phone
- (757) 385-0850
- Fax
- (757) 518-9713
- NPI assigned
- Oct 27, 2006
- Last updated
- Mar 13, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 0701003776 | VA | Primary |
Addresses
Primary practice location
289 Independence Blvd
Suite 245
Virginia Beach, VA 23462-5493
Mailing address
289 Independence Blvd
Suite 245
Virginia Beach, VA 23462-5493
Phone (757) 385-0850
Other names 1
- Ms. Stacie Thomas
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 21, 2024 through Mar 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0701003776 | VA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205366400000",
"number": "1790860559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "289 INDEPENDENCE BLVD",
"address_2": "SUITE 245",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234625493",
"telephone_number": "757-385-0850",
"fax_number": "757-518-9713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "289 INDEPENDENCE BLVD",
"address_2": "SUITE 245",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234625493",
"telephone_number": "757-385-0850",
"fax_number": "757-518-9713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "STACIE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2008-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "VA",
"license": "0701003776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "STACIE",
"last_name": "THOMAS",
"prefix": "MS.",
"credential": "LPC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.