Angela Davis, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC011237 Issued in GA

Practice address

4045 Orchard Rd SE Ste 110
Smyrna, GA 30080-4904

Phone

(770) 293-1950

NPI assigned

Aug 16, 2019

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

Opted out of Medicare

Yes, effective Mar 13, 2024 through Mar 13, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Healing Hearts Psychology Consultants, Inc.

  • Community/Behavioral Health Agency
  • Smyrna, GA
  • NPI 1891956306
  NPD (past)

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1992351654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 LATOUR DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300661971",
            "telephone_number": "770-310-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 ORCHARD RD SE STE 110",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804904",
            "telephone_number": "770-293-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANGELA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-16",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynda Dao, MD
• Dapss Lab Services, Inc
• Mervin Leroy Darter, MSW
• Priyanka Dave, PA-C
• Bibomba Davenport
• Aysha Davis
• Jane Moulder Davis, LPC
• Larry Matthew Davis, NP-C
• Richard Kyle Davis, PHARMD
• Janelle Lynette Davison, O.D.

• Mental Health Counselor in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.