MEDICARE: DR. DARCIE ALMA DAVIS-GAGE PH.D., LMHC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	001122	IA
2	101YP2500X	Professional Counselor	002434	MO
3	101YM0800X	Mental Health Counselor	001122	IA

General Provider Information

NPI Number	:	1184859829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARCIE ALMA DAVIS-GAGE PH.D., LMHC, LPC

Provider Business Mailing Address
First Line	:	6315 CHANCELLOR DR
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-6919
Country	:	US
Telephone Number	:	319-343-6762
Fax Number	:

Provider Business Practice Location Address
First Line	:	6315 CHANCELLOR DR STE 5
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-6919
Country	:	US
Telephone Number	:	319-343-6762
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	07/08/2022

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