Collin Davidson, PHD

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

LP5748 Issued in MN

Practice address

1221 W Lake St Ste 201
Minneapolis, MN 55408-3565

Phone

(303) 399-8020

NPI assigned

Apr 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1333238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562198400000",
    "number": "1821364001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 WENTWORTH AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554194941",
            "telephone_number": "405-612-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W LAKE ST STE 201",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083565",
            "telephone_number": "303-399-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "COLLIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-01",
        "last_updated": "2019-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MN",
            "license": "LP5748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa David, LICSW
• Helen Teresa Davido, MD
• Maria Davidsmeier, LICSW
• Ca'Mauri Maniyah Davidson
• Charme S. Davidson, PH.D., ABPP
• Jessica Rouchelle Davidson, RN
• Lars Davidson, DNP
• Lisa L Davidson, GNP
• Rebekah Grace Davidson, RN
• Zachary Davidson, MD

• Cognitive & Behavioral Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Cognitive & Behavioral Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 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.