Provider Demographics
NPI:1962644427
Name:DAVIS, KATHERINE VERLINE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:VERLINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 WERNER COURT, SUITE 305
Mailing Address - Street 2:K V DAVIS COUNSELING LLC
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-1321
Mailing Address - Country:US
Mailing Address - Phone:307-337-4673
Mailing Address - Fax:307-337-4674
Practice Address - Street 1:800 WERNER COURT, SUITE 305
Practice Address - Street 2:K V DAVIS COUNSELING LLC
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1321
Practice Address - Country:US
Practice Address - Phone:307-337-4673
Practice Address - Fax:307-337-4674
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-30
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1064101Y00000X, 101YP2500X
WYLPC-1064101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1343422400Medicaid