Kelsey Theresa Davidson, MA, LCDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDP00814 Issued in RI

Practice address

530 N Main St
Providence, RI 02904-5762

Phone

(781) 812-5163

NPI assigned

Sep 12, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1700436797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 CHARLTON AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606233",
            "telephone_number": "781-812-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045762",
            "telephone_number": "781-812-5163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KELSEY",
        "middle_name": "THERESA",
        "credential": "MA, LCDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "CDP00814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L.Kitzes,MD Inc
• David T. Barrall MD, Inc
• Jenny R David, DO
• Kayla E David, LMFT
• Duncan Ben Davidson, M.D.
• Robin Lynn Davidson, PA-C
• Abigail Cope Davies, MD
• Kristopher R Davignon, MD
• Rose Davilla
• Davinci Center for Community Progress

• All providers in Providence, RI
• Addiction (Substance Use Disorder) Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.