Provider Demographics
NPI:1316301781
Name:DAVIDS, CASEY NICOLE (MED, LPC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:NICOLE
Last Name:DAVIDS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13625 POND SPRINGS RD STE 105
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4400
Mailing Address - Country:US
Mailing Address - Phone:419-571-7965
Mailing Address - Fax:512-222-5145
Practice Address - Street 1:13625 POND SPRINGS RD STE 105
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4400
Practice Address - Country:US
Practice Address - Phone:419-571-7965
Practice Address - Fax:512-222-5145
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional