=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649309782
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAY LYNN DAVIES LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2007
-----------------------------------------------------
Last Update Date | 11/23/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4465 BOCA WAY SPC 146
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89502-6438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-830-0494
-----------------------------------------------------
Fax | 775-376-8549
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4420 SNOWSHOE LN
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89502-6431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-830-0494
-----------------------------------------------------
Fax | 775-337-4565
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 3035-C
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------