Individual provider Active NPI

Corey Molzon Davis, PSY.D.

  • Psychologist
  • Timonium, MD
National Provider Identifier
1245726280
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
06082 Issued in MD
Practice address
1400 Front Ave Ste 305
Timonium, MD 21093-5364
Phone
(908) 489-0551
NPI assigned
Jul 2, 2018
Last updated
Jul 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 06082 MD Primary

Addresses

Primary practice location

1400 Front Ave Ste 305
Timonium, MD 21093-5364

Mailing address

1400 Front Ave Ste 305
Timonium, MD 21093-5364
Phone (908) 489-0551

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

LicenseStateTypeSpecialty
06082MDMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1245726280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FRONT AVE STE 305",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210935364",
            "telephone_number": "908-489-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FRONT AVE STE 305",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210935364",
            "telephone_number": "908-489-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "COREY",
        "middle_name": "MOLZON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "06082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; 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.