Individual provider Active NPI

Kathryn Mae Davis, LCSW

  • Mental Health Counselor
  • Sherman Oaks, CA
National Provider Identifier
1487133195
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW110970 Issued in CA
Practice address
4401 Sepulveda Blvd Unit 210
Sherman Oaks, CA 91403-3934
Phone
(424) 218-9880
NPI assigned
Aug 13, 2018
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ASW101545 CA
Mental Health Counselor 101YM0800X LCSW110970 CA Primary

Addresses

Primary practice location

4401 Sepulveda Blvd Unit 210
Sherman Oaks, CA 91403-3934

Mailing address

4401 Sepulveda Blvd Unit 210
Sherman Oaks, CA 91403-3934
Phone (424) 218-9880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221218000012 CA Practitioner - Clinical Social Worker 1951770726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW101545CAMDMental Health Counselor
LCSW110970CAMDMental Health Counselor
110970CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Therapy Group, a Marriage and Family Therapy Corporation CurrentSince Sep 15, 2024 Accepting new patients

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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1487133195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 SEPULVEDA BLVD UNIT 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033934",
            "telephone_number": "424-218-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 SEPULVEDA BLVD UNIT 210",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914033934",
            "telephone_number": "424-218-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATHRYN",
        "middle_name": "MAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "ASW101545",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LCSW110970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.