Individual provider Active NPI

Savannah Marie Davis

  • Mental Health Counselor
  • Bend, OR
National Provider Identifier
1851725055
Registry record updated Mar 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
L10425 Issued in OR
Practice address
2041 NE Williamson CT Ste B
Bend, OR 97701-3941
Phone
(541) 837-6901
NPI assigned
Aug 25, 2013
Last updated
Mar 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X L10425 OR Primary
Mental Health Counselor 101YM0800X A4679 OR
Clinical Social Worker 1041C0700X A4679 OR
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

2041 NE Williamson CT Ste B
Bend, OR 97701-3941

Mailing address

2041 NE Williamson CT Ste B
Bend, OR 97701-3941
Phone (541) 837-6901

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L10425ORMDMental Health Counselor
A4679ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Crescent Counseling LLC CurrentSince Dec 24, 2023 Accepting new patients
New Tides Counseling and Wellness PastSince Dec 15, 2019 Accepting new patients

Locations

1011 SW Emkay Dr
Ste 207
Bend, OR 97702
Phone (541) 837-6901

2041 NE Williamson Ct
Ste B
Bend, OR 97701
Phone (541) 323-7546

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1377388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677888000000",
    "number": "1851725055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 NE WILLIAMSON CT STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013941",
            "telephone_number": "541-837-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 NE WILLIAMSON CT STE B",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013941",
            "telephone_number": "541-837-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAVANNAH",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-25",
        "last_updated": "2023-03-04",
        "certification_date": "2023-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L10425",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "A4679",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A4679",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2023; 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.