Krystal Mason Davis, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801093024 Issued in MI

Practice address

10 Peterboro
3Rd Floor Housing
Detroit, MI 48201

Phone

(313) 833-6685

Fax

(313) 833-4624

NPI assigned

Nov 3, 2011

Sex

Female

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

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Easterseals Morc Health Care, Inc.

  dba Easter Seals-Michigan, Inc

  • Psychiatry Physician
  • Auburn Hills, MI
  • NPI 1376526616
  Medicare reassignment NPD
• John Kitzmiller M.D. PC

  dba Bald Mountain Behavioral Medicine

  • Addiction Medicine (Family Medicine) Physician
  • Lake Orion, MI
  • NPI 1518393800
  Medicare reassignment NPD
• Mielke & Weeks, P. C.

  • Psychologist
  • Rochester Hills, MI
  • NPI 1144398504
  Medicare reassignment NPD
• Care Counseling Solutions LLC

  • Clinical Social Worker
  • Sterling Heights, MI
  • NPI 1215348529
  NPD Authorized official

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1679850713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PETERBORO",
            "address_2": "3RD FLOOR HOUSING",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-833-6685",
            "fax_number": "313-833-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PETERBORO",
            "address_2": "3RD FLOOR HOUSING",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-833-6685",
            "fax_number": "313-833-4624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KRYSTAL",
        "middle_name": "MASON",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Lenae Davis, LPN
• Kenya Davis
• Kienuwa Davis
• Kimberly C Davis
• Kristin Davis
• Lakeisha Davis, BA
• Lashawn Davis
• Latrice C Davis, RN
• Laura A Davis, RN
• Lauren Davis, LLP

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.