Active NPI
Davina Pettaway, MS,MA LPC, LICDC-CS
- Mental Health Counselor
- Dayton, OH
National Provider Identifier
1962994509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 140856
- Practice address
- 405 W 1St St
Dayton, OH 45402-3007 - Phone
- (937) 479-7010
- NPI assigned
- May 30, 2018
- 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 | 140856 | OH | Primary |
Addresses
Primary practice location
405 W 1St St
Dayton, OH 45402-3007
Mailing address
3094 Umberoak Dr
Dayton, OH 45449-3689
Phone (419) 932-5482
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
- Credentials
- Master of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 140856 | OH | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765497600000",
"number": "1962994509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3094 UMBEROAK DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454493689",
"telephone_number": "419-932-5482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 W 1ST ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454023007",
"telephone_number": "937-479-7010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTAWAY",
"first_name": "DAVINA",
"credential": "MS,MA LPC, LICDC-CS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-30",
"last_updated": "2025-12-12",
"certification_date": "2025-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OH",
"license": "140856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.