Healthcare Provider Details

I. General information

NPI: 1316790942
Provider Name (Legal Business Name): KRISTEN DAVIDSON, PSY.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 AVALON PARK EAST BLVD STE 200
ORLANDO FL
32828-4902
US

IV. Provider business mailing address

13606 CASSIOPEIA DR
ORLANDO FL
32828-9310
US

V. Phone/Fax

Practice location:
  • Phone: 407-793-1282
  • Fax: 833-895-1282
Mailing address:
  • Phone: 405-315-3070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTEN MICHELLE DAVIDSON
Title or Position: CLINICAL NEUROPSYCHOLOGIST
Credential: PSYD
Phone: 407-793-1282