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General NPI Number Information
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NPI Number | 1184387581
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Entity Type | Individual
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Provider Name | KYRBI AMELIA DAVIS LCSW, LCDC
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Gender | Female
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Dates
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Enumeration Date | 10/21/2021
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Last Update Date | 12/29/2023
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Provider Practice Location Address
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Address Line | 12234 SHADOW CREEK PKWY BUILDING 10, SUITE 106
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City | PEARLAND
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State | TX
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Zip | 77584
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Country | US
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Telephone | 737-241-8677
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Fax |
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Provider Business Mailing Address
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Address Line | 3519 E WALNUT ST # 3294
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City | PEARLAND
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State | TX
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Zip | 77581-4717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15232
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 66931
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License Number State | TX
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