Active NPI
Timothy L Davis, LPC
- Professional Counselor
- Kingman, AZ
National Provider Identifier
1770565269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC 10479
- Practice address
- 1743 Sycamore Ave
Kingman, AZ 86409-0927 - Phone
- (928) 757-8111
- Fax
- (928) 757-3256
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC 10479 | AZ | Primary |
Addresses
Primary practice location
1743 Sycamore Ave
Kingman, AZ 86409-0927
Mailing address
1743 Sycamore Ave
Kingman, AZ 86409
Phone (928) 757-8111
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 |
|---|---|---|---|
| LPC 10479 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1770565269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1743 SYCAMORE AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "86409",
"telephone_number": "928-757-8111",
"fax_number": "928-757-3256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1743 SYCAMORE AVE",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864090927",
"telephone_number": "928-757-8111",
"fax_number": "928-757-3256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TIMOTHY",
"middle_name": "L",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC 10479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingman, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.