Individual provider Active NPI

Kimberly S Yon-Davis, LCSW

  • Clinical Social Worker
  • Destin, FL
National Provider Identifier
1992129290
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11761 Issued in FL
Practice address
4393 Commons Dr E Ste 200
Destin, FL 32541-8482
Phone
(850) 974-8045
Fax
(850) 678-1720
NPI assigned
Feb 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW11761 FL Primary

Addresses

Primary practice location

4393 Commons Dr E Ste 200
Destin, FL 32541-8482

Mailing address

1512 John Sims Pkwy E # 353
Niceville, FL 32578-2143
Phone (850) 974-8045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20140804000539 FL Practitioner - Clinical Social Worker 3971720673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4393 Commons Dr E
Destin, FL 32541-8482
Phone (850) 974-8045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly Yon-Davis, LCSW, PLLC Clinical CurrentSince Aug 17, 2015 Accepting new patients

Locations

4393 Commons Dr E
Ste 200
Destin, FL 32541
Phone (850) 974-8045

4393 Commons Dr E
Ste 201
Destin, FL 32541
Phone (850) 974-8045

3997 Commons Dr W
Ste C
Destin, FL 32541
Phone (850) 217-5874

1512 John Sims Pkwy E
Niceville, FL 32578
Phone (601) 670-1539

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1992129290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 JOHN SIMS PKWY E # 353",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325782143",
            "telephone_number": "850-974-8045",
            "fax_number": "850-678-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4393 COMMONS DR E STE 200",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418482",
            "telephone_number": "850-974-8045",
            "fax_number": "850-678-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YON-DAVIS",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Destin, FL

Sources for this page

Verify at the official NPI Registry.