Active NPI
Victoria Lynn Davis, LCSW
- Mental Health Counselor
- Lacey, WA
National Provider Identifier
1851463095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LW00004074
- Practice address
- 4422 6TH Ave SE
Lacey, WA 98503-1020 - Phone
- (360) 704-7170
- Fax
- (360) 412-4982
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LW00004074 | WA | Primary |
Addresses
Primary practice location
4422 6TH Ave SE
Lacey, WA 98503-1020
Mailing address
3857 Martin Way E
Olympia, WA 98506-5268
Phone (360) 714-7170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW00004074 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Health Resources | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Elma, WA
- NPI 1306918750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851463095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3857 MARTIN WAY E",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065268",
"telephone_number": "360-714-7170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4422 6TH AVE SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985031020",
"telephone_number": "360-704-7170",
"fax_number": "360-412-4982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "VICTORIA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LW00004074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.