Carl D Davis Jr.
Individual provider Active NPI Cognitive & Behavioral Psychologist · Windsor, MO
NPI 1366468126 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1366468126
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cognitive & Behavioral Psychologist 103TB0200X
- License
- 2002030477 (MO)
- Practice address
- 307 N Main St
Windsor, MO 65360-1449 - Phone
- (660) 647-9921
- Fax
- (660) 647-3617
- NPI assigned
- Jul 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Family Healthcare, Inc. | Past |
Accepting new patients | |
| Midwest Behavioral Health, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 2002030477 | MO | Yes |
Addresses
Primary practice location
307 N Main St
Windsor, MO 65360-1449
Mailing address
2701 Station Ave
Sedalia, MO 65301-6778
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 498319300 | Medicaid | MO |
Other providers in Windsor, MO
- Brown & Associates of Windsor, LLC
- Cassie Elizabeth Brown
- Lisa D Brown
- Brandon Beck Carroll
- Amie Lynn Cooper
- Latasha Sunshine Dean
- Jennifer G. Dier
- Amie Lynn Etters
- Patrick James Fletcher
- Fresh Start Adult Day Care of Missouri Inc
All providers in Windsor, MO · Cognitive & Behavioral Psychologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.