Active NPI
Kimberlie N Davidson, LPC-A
- Counselor
- Fountain Inn, SC
National Provider Identifier
1669209573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 10097
- Practice address
- 105 N Kings Dr
Fountain Inn, SC 29644-9459 - Phone
- (828) 273-6234
- NPI assigned
- Sep 16, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 10097 | SC | Primary |
Addresses
Primary practice location
105 N Kings Dr
Fountain Inn, SC 29644-9459
Mailing address
105 N Kings Dr
Fountain Inn, SC 29644-9459
Phone (828) 273-6234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10097 | SC | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726444800000",
"number": "1669209573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N KINGS DR",
"city": "FOUNTAIN INN",
"state": "SC",
"postal_code": "296449459",
"telephone_number": "828-273-6234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N KINGS DR",
"city": "FOUNTAIN INN",
"state": "SC",
"postal_code": "296449459",
"telephone_number": "828-273-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "KIMBERLIE",
"middle_name": "N",
"credential": "LPC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-16",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "SC",
"license": "10097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fountain Inn, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.