JUSTIN DAVIS LGP
NPI 1417486101
Counselor in Cumberland, MD

Q: What is Justin Davis's NPI number?

The NPI number for Justin Davis is 1417486101. It was assigned to this individual provider in the NPPES registry on June 7, 2017.

Q: What is Justin Davis's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Justin Davis was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 07, 2017PECOS Enrolled

12502 WILLOWBROOK RD STE 380, CUMBERLAND, MD 21502(240) 964-8585(240) 964-8586 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jun 7, 2017 (2 updates tracked since 2017).

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About Justin Davis Lgp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN DAVIS LGP (NPI 1417486101) is an individual counselor in Cumberland, Maryland, licensed in Maryland (LGP6648) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417486101

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameJUSTIN DAVISCredential: LGP

Location Address12502 WILLOWBROOK RD STE 380Cumberland, MD 21502-6592

Mailing Address12502 Willowbrook Rd Ste 380Cumberland, MD 21502-6592 · (240) 964-8585 · Fax (240) 964-8586

Phone(240) 964-8585

Fax(240) 964-8586

Sole ProprietorYes

Enumeration DateJune 7, 2017

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1417486101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in MD · LGP6648

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

12502 WILLOWBROOK RD STE 380, Cumberland, MD 21502

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Davis Lgp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY HAROLD LGPC

Counselor (Professional)