Linda Ellen Davidson, M.S.

Individual provider Active NPI Clinical Psychologist · Nevada, MO

NPI 1801904792 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1801904792
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
01384 (MO)
Practice address
212 N Main St
Nevada, MO 64772-2332
Phone
(417) 667-9608
Fax
(417) 667-9713
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 01384 MO Yes

Addresses

Primary practice location

212 N Main St
Nevada, MO 64772-2332

Mailing address

PO Box 607
Nevada, MO 64772-0607
Phone (417) 667-9608

Other identifiers

IdentifierTypeStateIssuer
24567024OtherMOBCBS OF KC

Other providers in Nevada, MO

All providers in Nevada, MO · Clinical Psychologist in Missouri

Sources for this page

Verify at the official NPI Registry.