Kimberly Ann Davis, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11937 Issued in FL

Practice address

1705 Emerson St
Jacksonville, FL 32207-6105

Phone

(904) 384-4910

Fax

(904) 389-9220

NPI assigned

Oct 29, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Ann Miller Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• In-Trinsic, Inc.

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1114173663
  NPD (past)

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1184029498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 EMERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076105",
            "telephone_number": "904-384-4910",
            "fax_number": "904-389-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 EMERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076105",
            "telephone_number": "904-384-4910",
            "fax_number": "904-389-9220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "439 SW Michigan St",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320250440",
            "country_code": "US",
            "telephone_number": "386-487-0800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MILLER",
            "middle_name": "ANN",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kellam Davis
• Kendra L Davis, CPHT, RPHT
• Kenya Malyka Davis, MA
• Kevin Wayne Davis II, PHARM.D.
• Kimberly A Davis, DOULA
• Kimberly Renee Davis, APRN
• King Rosevelt Davis, APRN
• Latoya Denise Davis, LMHC
• Laura Anne Davis, AGACNP, BC
• Laura D Davis, OT

• Mental Health Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.