Gabrielle J Davis, LAC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00400000 Issued in NJ

Practice address

166 Main St
Matawan, NJ 07747

Phone

(732) 290-9040

NPI assigned

Jan 28, 2018

Last updated

Jun 18, 2018By the provider in NPPES

Sex

Female

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Exceptional Wellness Counseling, Inc.

  • Clinical Social Worker
  • Manalapan, NJ
  • NPI 1639613862
  Medicare reassignment

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

{
    "created_epoch": "1517097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1871091579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "077473104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "city": "MATAWAN",
            "state": "NJ",
            "postal_code": "07747",
            "telephone_number": "732-290-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GABRIELLE",
        "middle_name": "J",
        "credential": "LAC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-28",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00400000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Daly
• Robert Lawrence Daly Jr., MA, LAC
• Andrew Daniele, DC
• Heather Daniele, FNTP
• Reyan Dar-Elnajar
• Kelly Anne Davis, MA, LAC
• Ida Vernelius Davistyson
• Maria Eduarda De Souza Melo
• Pamela A Deandrea, APN
• Racquel Decaro, DC

• Mental Health Counselor in Matawan, NJ
• Providers in Matawan, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.