Mariah Davidson-Vader, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC.0021358 Issued in CO

Practice address

1 Western Way
Crystal Hall 104
Gunnison, CO 81230

Phone

(970) 648-7128

NPI assigned

Nov 13, 2024

Last updated

Nov 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mariah.davidson-vader.1@11629.direct.athenahealth.com
• Direct secure messaging: mariah.davidson-vader@489656322949124.direct.elationemr.com

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.

• Gunnison Valley Hospital

  dba Gunnison Valley Behavioral Health Clinic WCU

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gunnison, CO
  • NPI 1033990064
  NPD

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1922822246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W DENVER AVE APT A",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "812303382",
            "telephone_number": "303-257-5487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WESTERN WAY",
            "address_2": "CRYSTAL HALL 104",
            "city": "GUNNISON",
            "state": "CO",
            "postal_code": "81230",
            "telephone_number": "970-648-7128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON-VADER",
        "first_name": "MARIAH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0021358",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CO",
            "license": "OTA.0000680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Crisi, RN
• Nicole Cullinan, PT
• Christina Joanne Damm, PHARMD
• Darrick J. Zirker, DDS, PC
• Elizabeth Katie Dautrich, LAC
• Keith E Davis, MD
• Annalisa Dietz, BCBA
• Dillon Companies LLC (City Market Pharmacy)
• Bryan Dillon, LPCC
• Kristen Dirksen

• Professional Counselor in Gunnison, CO
• Providers in Gunnison, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.