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1023626843 NPI number — CHRISTINA MACHELLE DAVIS P-LPC, M.S.

NPI Number: 1023626843
Health Care Provider/Practitioner: CHRISTINA MACHELLE DAVIS P-LPC, M.S.

Information about “1023626843” NPI (CHRISTINA MACHELLE DAVIS P-LPC, M.S.) exists in 1023626843 in HTML format HTML  |  1023626843 in plain Text format TXT  |  1023626843 in PDF (Portable Document Format) PDF  |  1023626843 in an XML format XML  formats.

NPI Number : 1023626843 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023626843",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DAVIS",
    "FirstName": "CHRISTINA",
    "MiddleName": "MACHELLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "P-LPC, M.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "346 CARTER RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BILOXI",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "39531-2804",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "228-243-3421",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2352 E PASS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GULFPORT",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39507-3805",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "228-284-2337",
    "PracticeLocationAddressFaxNumber": "228-284-2337",
    "EnumerationDate": "07/17/2020",
    "LastUpdateDate": "07/17/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YM0800X",
        "TaxonomyName": "Mental Health Counselor",
        "LicenseNumber": "P-0584",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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