Taquez Davis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

D09217328307962 Issued in NJ

Practice address

136 S 3Rd St
Millville, NJ 08332-5301

Phone

(803) 806-2596

NPI assigned

Oct 17, 2016

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1982155792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 S 3RD ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083325301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S 3RD ST",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083325301",
            "telephone_number": "803-806-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TAQUEZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "D09217328307962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sandra Lee Cunningham, M.S.W./L.S.W.
• Nitesh Darji
• Brian J Davis, DO
• Shatia Dawkins, LCADC
• Kelly Delahunty
• Stacey Lynn Delano, PT
• Delta Community Supports, Inc.
• Delta Community Supports, Inc.

• All providers in Millville, NJ
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.