Camille A Davis, LCSW, LSCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2024002625 Issued in MO

Practice address

9 SE 3Rd St Ste 206
Lees Summit, MO 64063-2322

Phone

(316) 807-1365

NPI assigned

Jun 15, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Sedgwick

  • Public Health or Welfare Agency
  • Wichita, KS
  • NPI 1629281373
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1053673913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SE 3RD ST STE 206",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632322",
            "telephone_number": "913-214-1769",
            "fax_number": "816-693-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SE 3RD ST STE 206",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640632322",
            "telephone_number": "316-807-1365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Gillham Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641084619",
            "country_code": "US",
            "telephone_number": "816-701-5209",
            "fax_number": "816-302-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CAMILLE",
        "middle_name": "A",
        "credential": "LCSW, LSCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2024002625",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "05831",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Daniels, LPN
• David E Orson, OD, PC
• Sean Richard Davidson, MD
• Katelyn Davies
• Kendra Deanne Davis-Leighty, LCSW
• Carl Spencer Davis, M.D.
• Gregory Roger Davis, D.C.
• Gretchen Davis, FNP-C
• John M. Davis II, M.D.
• Katherine Sydney Davis, FNP-C

• Clinical Social Worker in Lees Summit, MO
• Providers in Lees Summit, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.