Healthcare Provider Details

I. General information

NPI: 1245156298
Provider Name (Legal Business Name): KRISLYN DAVIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 J DEWEY GRAY CIR STE B
AUGUSTA GA
30909-6512
US

IV. Provider business mailing address

246 ROBERT C DANIEL JR PKWY # 1145
AUGUSTA GA
30909-0803
US

V. Phone/Fax

Practice location:
  • Phone: 706-364-3470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC016821
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: