Timothy L Davis, LPC
Counselor, Professional in Kingman, AZ. Individual provider (NPI-1).
NPI number1770565269
StatusActive
Last updated in NPPESJul 22, 2011
Details
- NPI
- 1770565269
- Entity type
- Individual (NPI-1)
- Name
- Timothy L Davis
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 18, 2005
- Last updated
- Jul 22, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | LPC 10479 | AZ | Yes |
Practice location
1743 Sycamore AveKingman, AZ 86409-0927
Phone 928-757-8111 · Fax 928-757-3256
Mailing address
1743 Sycamore AveKingman, AZ 86409
Phone 928-757-8111 · Fax 928-757-3256
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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