Healthcare Provider Details
I. General information
NPI: 1518540160
Provider Name (Legal Business Name): KIMBERLY DAVIS MCLEOD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/02/2021
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1305 ELBA HWY
TROY AL
36079-6039
US
IV. Provider business mailing address
1305 ELBA HWY
TROY AL
36079-6039
US
V. Phone/Fax
- Phone: 334-770-1423
- Fax: 334-770-1424
- Phone: 334-443-1423
- Fax: 334-770-1424
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | LPC05018 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: