Provider Demographics
NPI:1558187625
Name:DAVIS, KATHRYN CLAIRE (LICSW-S, PIP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:CLAIRE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LICSW-S, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 SAULTER RD
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6250
Mailing Address - Country:US
Mailing Address - Phone:205-306-4295
Mailing Address - Fax:
Practice Address - Street 1:300 VESTAVIA PKWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35216-7714
Practice Address - Country:US
Practice Address - Phone:205-306-4295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4648C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical