Individual provider Active NPI

Sandra Goodrich Davis, LMHC

  • Mental Health Counselor
  • Kissimmee, FL
National Provider Identifier
1427008036
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH5015 Issued in FL
Practice address
600 N Thacker Ave
Suite a-1
Kissimmee, FL 34741-4892
Phone
(407) 870-5788
Fax
(407) 870-2766
NPI assigned
May 12, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH5015 FL Primary

Addresses

Primary practice location

600 N Thacker Ave
Suite a-1
Kissimmee, FL 34741-4892

Mailing address

600 N Thacker Ave
Suite a-1
Kissimmee, FL 34741-4892
Phone (407) 870-5788

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
I20260109001380 FL Practitioner - Mental Health Counselor 8224514260 Practice locations: Kissimmee, FL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3501 W Vine St
Suite 508
Kissimmee, FL 34741-4601
Phone (407) 870-5788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH5015FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1427008036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N THACKER AVE",
            "address_2": "SUITE A-1",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414892",
            "telephone_number": "407-870-5788",
            "fax_number": "407-870-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N THACKER AVE",
            "address_2": "SUITE A-1",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414892",
            "telephone_number": "407-870-5788",
            "fax_number": "407-870-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SANDRA",
        "middle_name": "GOODRICH",
        "name_prefix": "Dr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.