Active NPI
Kevin Patrick Davidson, LPC
- Professional Counselor
- Wylie, TX
National Provider Identifier
1073501631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 66038
- Practice address
- 203 N Jackson Ave
Wylie, TX 75098-4444 - Phone
- (972) 442-7770
- Fax
- (972) 442-7771
- NPI assigned
- Oct 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | RS141297 | OH | |
| Professional Counselor | 101YP2500X | 66038 | TX | Primary |
| Professional Counselor | 101YP2500X | E.00007850 | OH |
Addresses
Primary practice location
203 N Jackson Ave
Wylie, TX 75098-4444
Mailing address
1110 E Branch Hollow Dr Apt 385
Carrollton, TX 75007-1091
Phone (972) 786-1701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E.00007850 | OH | MD | Professional Counselor |
| RS141297 | OH | MD | Professional Counselor |
| 66038 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291593600000",
"number": "1073501631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 E BRANCH HOLLOW DR APT 385",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750071091",
"telephone_number": "972-786-1701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 N JACKSON AVE",
"city": "WYLIE",
"state": "TX",
"postal_code": "750984444",
"telephone_number": "972-442-7770",
"fax_number": "972-442-7771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "KEVIN",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-07",
"last_updated": "2010-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "RS141297",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "66038",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E.00007850",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wylie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.