Richard David Davidson, MS, LADC, CRC, CVRT,
Counselor, Addiction (Substance Use Disorder) in Broken Arrow, OK. Individual provider (NPI-1).
NPI number1992983407
StatusActive
Last updated in NPPESAug 25, 2015
Details
- NPI
- 1992983407
- Entity type
- Individual (NPI-1)
- Name
- Richard David Davidson
- Credential
- MS, LADC, CRC, CVRT,
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 6, 2008
- Last updated
- Aug 25, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 103TR0400X | Psychologist, Rehabilitation | – | – | |
| 103TC1900X | Psychologist, Counseling | – | – | |
| 103TB0200X | Psychologist, Cognitive & Behavioral | – | – |
Practice location
3718 S Elm PlSuite 3718
Broken Arrow, OK 74011-1803
Phone 918-994-1510
Mailing address
3718 S Elm PlSuite 3718
Broken Arrow, OK 74011-1803
Phone 918-994-1510
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Addiction (Substance Use Disorder) Counselor providers in Broken Arrow, OK
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All 9 Addiction (Substance Use Disorder) Counselor providers in Broken Arrow · All 2,347 providers in Broken Arrow
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