Kindall Davis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC009970 Issued in PA

Practice address

2400 Ansys Dr.
Ste 102
Canonsburg, PA 15317

Phone

(412) 737-0990

Fax

(412) 533-2696

NPI assigned

May 3, 2017

Sex

Female

Sole proprietor

No

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

Practice roles

Locations

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.

• Mindful Tides Therapy LLC

  • Professional Counselor
  • Canonsburg, PA
  • NPI 1750086500
  NPD Authorized official

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1073049581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 CRAIG ST",
            "city": "IMPERIAL",
            "state": "PA",
            "postal_code": "151269744",
            "telephone_number": "412-259-3394",
            "fax_number": "412-533-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ANSYS DR.",
            "address_2": "STE 102",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "15317",
            "telephone_number": "412-737-0990",
            "fax_number": "412-533-2696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KINDALL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC009970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elviira Craig, D.O.
• Creative Counseling Associates, P.C.
• Michael William Cutlip, MA, LPC
• Sina D'Amico, RDN
• Erin Michelle Davis, MS, OTR/L
• Nicholas Debiec
• Deconcilis Eye and Vision Center, PC
• Nathaniel Douglas Deitrick, DC,CSCS
• Anthony Michael Deloe
• Emma Marie Denlinger

• Professional Counselor in Canonsburg, PA
• Providers in Canonsburg, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.