Susan K Davidson, MS, LMFT
Individual provider Active NPI Marriage & Family Therapist · Hattiesburg, MS
NPI 1306134846 · NPPES record last updated Jul 19, 2011
Key facts
- NPI
- 1306134846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- T0440 (MS)
- Practice address
- 5 Orleans Dr
Suite 2
Hattiesburg, MS 39402-8675 - Phone
- (601) 818-0167
- NPI assigned
- Jul 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T0440 | MS | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathway Counseling Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T0440 | MS | Yes |
Addresses
Primary practice location
5 Orleans Dr
Suite 2
Hattiesburg, MS 39402-8675
Mailing address
9A Heartwood Place
Hattiesburg, MS 39402
Phone (601) 818-0167
Other providers in Hattiesburg, MS
- Evan Henry Dart
- Mehjabeen Darugar
- Geralyn Datz
- Patrick D Dauphin
- David M. Perez, DMD, P.C.
- Shannon Davis Sims
- Allyson Davis
- Angela Anita Davis
- Carmen Davis
- Chad Joseph Davis
All providers in Hattiesburg, MS · Marriage & Family Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.