Individual provider Active NPI

Destiny Davis

  • Professional Counselor
  • Atlanta, GA
National Provider Identifier
1881210201
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC013144 Issued in GA
Practice address
1249 Hartford Ave SW
Atlanta, GA 30310-4216
Phone
(404) 905-3391
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC013144 GA Primary
Professional Counselor 101YP2500X APC007491 GA

Addresses

Primary practice location

1249 Hartford Ave SW
Atlanta, GA 30310-4216

Mailing address

1249 Hartford Ave SW
Atlanta, GA 30310-4216
Phone (860) 605-7944

Other practice location 1

6100 Lake Forrest Dr Ste 450
Atlanta, GA 30328-3837
Phone (678) 984-6722

Other practice location 2

900 Dekalb Ave NE Ste K
Atlanta, GA 30307-2501
Phone (404) 905-3391

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
APC007491GAMDProfessional Counselor
LPC013144GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Active Care Counseling & Coaching Professional CurrentSince Feb 8, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1881210201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1249 HARTFORD AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303104216",
            "telephone_number": "860-605-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1249 HARTFORD AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303104216",
            "telephone_number": "404-905-3391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Lake Forrest Dr Ste 450",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303283837",
            "country_code": "US",
            "telephone_number": "678-984-6722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Dekalb Ave NE Ste K",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303072501",
            "country_code": "US",
            "telephone_number": "404-905-3391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DESTINY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC013144",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC007491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.