Catherine C Davis, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CCMH0164081 Issued in NM

Practice address

4313 Corrales Rd, Office #1
Corrales, NM 87048

Phone

(505) 818-8759

NPI assigned

Dec 9, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1992008122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W ELLA DR",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870487241",
            "telephone_number": "505-818-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 CORRALES RD, OFFICE #1",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "87048",
            "telephone_number": "505-818-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CATHERINE",
        "middle_name": "C",
        "credential": "MA, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0164081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05731003",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corrales Family Practice LLC
• Corrales Therapy LLC
• Corrales Voice & Speech Therapy, LLC
• Jay Patrick Crowe, LISW
• Darren Braude, MD, LLC
• Designed Health Options, LLC
• Sahnta Lee Di Cesare-Pannutti, LPAT
• Brian Dickert, DC
• Patricia Anne Dubois, LISW
• Lisa Eckelkamp, MS, CCC-SLP, BCBA

• All providers in Corrales, NM
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.