Izaak Davison-Kerwood

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

IZAAK DAVISON-KERWOOD

Practice address

1713 Tyler St NE Unit 2
Minneapolis, MN 55413-1533

Phone

(612) 850-1006

NPI assigned

Sep 30, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Izaak River Davison-Kerwood, LPCCNPI 1528666898

Title

Ceo

Phone

(612) 850-1006

Specialties & licenses 1

Addresses

Other names 1

• Izaak Davison-Kerwood, LLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Izaak River Davison-Kerwood

  • Mental Health Counselor
  • Portsmouth, VA
  • NPI 1528666898
  NPD Authorized official

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1790503704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 TYLER ST NE UNIT 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131533",
            "telephone_number": "612-850-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 TYLER ST NE UNIT 2",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131533",
            "telephone_number": "612-850-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IZAAK DAVISON-KERWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "DAVISON-KERWOOD",
        "authorized_official_first_name": "IZAAK",
        "authorized_official_middle_name": "RIVER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-850-1006",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Izaak Davison-Kerwood, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Izaak Davison-Kerwood, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Carlos A Iwamoto, M.D.
• Taylor Lynn Iwaszko Wagner, CNP-PNP
• Kyra A. Iwen, DDS
• Uroghupatei Paul Iyegha, MD
• Vishnu Iyer, MD
• Adaobi Nneamaka Izuora
• Izzy Homecare LLC
• J All Metero Services Inc
• J Taborn Associates Inc
• J. Maris Gilbert

• Mental Health Counselor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.