Individual provider Active NPI

Cynthia S Davey, PH.D. CLINICAL PSYCH

  • Mental Health Counselor
  • Fort Myers, FL
National Provider Identifier
1245640473
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 10313 Issued in FL
Practice address
1937 Grace Ave Ste 100
Fort Myers, FL 33901-7119
Phone
(239) 340-5589
NPI assigned
Apr 28, 2014
Last updated
Dec 12, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 10313 FL Primary
Clinical Psychologist 103TC0700X MH10313 FL

Addresses

Primary practice location

1937 Grace Ave Ste 100
Fort Myers, FL 33901-7119

Mailing address

1937 Grace Ave Ste 100
Fort Myers, FL 33901-7119
Phone (239) 340-5589

Other identifiers 1

IdentifierTypeStateIssuer
MH10313OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240520003127 FL Practitioner - Mental Health Counselor 8729300728 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MH 10313FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cotler Healthcare & Development Inc. Clinical CurrentSince Apr 10, 2024 Accepting new patients
CD Psychological Practice, PA Mental Health Past Accepting new patients

Locations

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418342400000",
    "number": "1245640473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 GRACE AVE STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017119",
            "telephone_number": "239-340-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 GRACE AVE STE 100",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017119",
            "telephone_number": "239-340-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVEY",
        "first_name": "CYNTHIA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PH.D. CLINICAL PSYCH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 10313",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "MH10313",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MH10313",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.