Keli Davis

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7187 Issued in SC

Practice address

1340 Celebration Blvd
Florence, SC 29501-5585

Phone

(843) 536-1180

NPI assigned

Nov 23, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellspring Psychology Group LLCGroup PAC ID 9537382692, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wellspring Psychology Group LLC

  • Clinical Psychologist
  • Florence, SC
  • NPI 1255756565
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1881298602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1204",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295031204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CELEBRATION BLVD",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015585",
            "telephone_number": "843-536-1180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3439 Casey St",
            "address_purpose": "LOCATION",
            "city": "Loris",
            "state": "SC",
            "postal_code": "295692903",
            "country_code": "US",
            "telephone_number": "843-756-7171",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "411 W Hampton St",
            "address_purpose": "LOCATION",
            "city": "Dillon",
            "state": "SC",
            "postal_code": "295363337",
            "country_code": "US",
            "telephone_number": "843-765-4087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KELI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "7187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdavis.sc@familyfirst1.com",
            "affiliation": "N",
            "endpointDescription": "Primary Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "411 W Hampton St",
            "city": "Dillon",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295363337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dannielle Davis
• Gwen A Davis, RN
• Kamren Warren Davis
• Katie Davis, PTA
• Katie Taylor Davis
• Linda L Davis, BSW
• Linda S. Davis, LPC
• Maria Shyree Davis, LPC-A
• Paul Thomas Davis II, DMD
• Richard Franklin Davis, M.D.

• Mental Health Counselor in Florence, SC
• Providers in Florence, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.