Individual provider Active NPI

Karshibia Davidson, MS, LPC, NCC

  • Mental Health Counselor
  • Oxford, MI
National Provider Identifier
1255612883
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401011772 Issued in MI
Practice address
322 Franklin Lake Cir
Oxford, MI 48371-6704
Phone
(888) 788-7145
Fax
(888) 788-1564
NPI assigned
Sep 9, 2011
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401011772 MI
Mental Health Counselor 101YM0800X 6401011772 MI Primary
Professional Counselor 101YP2500X 6401011772 MI

Addresses

Primary practice location

322 Franklin Lake Cir
Oxford, MI 48371-6704

Mailing address

322 Franklin Lake Cir
Oxford, MI 48371-6704
Phone (888) 788-7145

Other names 1

  • Karshibia Lloyd Davidson Tuckey Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.therapyportal.com/p/lloydhuman/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240305001459 MI Practitioner - Mental Health Counselor 0749625366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Counseling Center,P.C.Group PAC ID 1759370208, 17 clinicians

Practice addresses (Care Compare)

520 Superior St
Port Huron, MI 48060-3838
Phone (810) 984-4202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6401011772MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Counseling Center,P.C. CurrentSince Feb 5, 2024 Accepting new patients
Lloyd Human Services, LLC Mental Health CurrentSince Jun 27, 2021 Accepting new patients

Locations

520 Superior St
Port Huron, MI 48060
Phone (810) 455-0102

852 32nd St
Unit 611140
Port Huron, MI 48061

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": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1255612883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 FRANKLIN LAKE CIR",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483716704",
            "telephone_number": "888-788-7145",
            "fax_number": "888-788-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 FRANKLIN LAKE CIR",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483716704",
            "telephone_number": "888-788-7145",
            "fax_number": "888-788-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KARSHIBIA",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401011772",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401011772",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.therapyportal.com/p/lloydhuman/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "322 Franklin Lake Cir",
            "city": "Oxford",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483716704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KARSHIBIA",
            "last_name": "LLOYD DAVIDSON TUCKEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oxford, MI

Sources for this page

Verify at the official NPI Registry.