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NPI Code Detail

MEDICARE: ADAM DAVIS MA, LPC

MEDICARE: ADAM DAVIS MA, 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
1101YM0800XMental Health Counselor
2101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710505417
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM DAVIS MA, LPC
Provider Business Mailing Address
First Line : 6343 W 120TH AVE STE 105
Second Line :
City : BROOMFIELD
State : CO
Zip : 80020-3701
Country : US
Telephone Number : 720-380-3564
Fax Number :
Provider Business Practice Location Address
First Line : 950 S CHERRY ST STE 1675
Second Line :
City : DENVER
State : CO
Zip : 80246-2532
Country : US
Telephone Number : 720-380-3564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2020
Last Update Date : 09/01/2024

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Directions to “ ADAM DAVIS MA, LPC” Practice Location

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