Courtney Davis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

9317 Madina Pkwy
Fort Wayne, IN 46825-1134

Phone

(260) 580-1996

NPI assigned

Mar 28, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Terracedar Services, LLC

  • Day Training/Habilitation Specialist
  • Fort Wayne, IN
  • NPI 1285285973
  NPD

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1831849215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 E DUPONT RD # 97",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468252051",
            "telephone_number": "260-580-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9317 MADINA PKWY",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251134",
            "telephone_number": "260-580-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "COURTNEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Davidson
• Kalah D Davis-Brown, RBT
• Ashley Davis, M.A., LMHC
• Brittany Davis, RBT
• Claudia D Davis, MSW, LCSW
• Dominique Alysia Davis
• Elizabeth Davis, RBT
• Elizabeth Davis, AUD
• Eric Davis
• Felicity Davis

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.