Kevin Edward Davis, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37AC00825900 Issued in NJ

Practice address

750 NJ-73
Suite 210
Evesham, NJ 08053

Phone

(856) 399-1010

NPI assigned

Feb 28, 2025

Last updated

Feb 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Synapse Behavioral Health Inc

  • Psychiatry Physician
  • Voorhees, NJ
  • NPI 1679114292
  NPD (past)

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1508663238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PARK DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023754",
            "telephone_number": "609-780-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 NJ-73",
            "address_2": "SUITE 210",
            "city": "EVESHAM",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-399-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KEVIN",
        "middle_name": "EDWARD",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00825900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronita Chambers
• Yadid Chaniz-Rico
• Tamara Clara Christian
• Kathleen Connelly, LAC
• CSH Marlton Lessee, LLC (Arbor Terrace Marlton)
• Marybeth Deangelis, BSN, RN
• Dental Arts & Wellness LLC
• Danielle Dolores, RPH
• Extraordinary Minds
• Eyes on Evesham, L.L.C.

• Professional Counselor in Evesham, NJ
• Providers in Evesham, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.