Kimberlie N Davidson, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

12574 Issued in SC

Practice address

105 N Kings Dr
Fountain Inn, SC 29644-9459

Phone

(828) 273-6234

NPI assigned

Sep 16, 2024

Last updated

Sep 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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.

• Yemaya Restorative Health

  • Professional Counselor
  • Fountain Inn, SC
  • NPI 1730086364
  NPD (past) Authorized official

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "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": "864-962-7173"
        },
        {
            "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",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "12574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Anthony Constantine, D.D.S.
• Constantly Caring Medical Services
• Bonnie J Crandell, MS, CCC-SLP
• Nathan Cripps, PT, DPT
• Haylee Croslow
• Sarah A. Derrick, F.N.P.
• Jessica Dominguez
• Melissa Douge, DO
• Kala Marissa Elamparo, RN
• Enormous Grace Inc.

• Counselor in Fountain Inn, SC
• Providers in Fountain Inn, SC by specialty
• Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; 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.