MEDICARE: KIMBERLY DAVIS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1265635312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY DAVIS LCSW

Provider Business Mailing Address
First Line	:	2973 W 3150 N
Second Line	:
City	:	PLAIN CITY
State	:	UT
Zip	:	84404-6797
Country	:	US
Telephone Number	:	801-652-7127
Fax Number	:

Provider Business Practice Location Address
First Line	:	2973 W 3150 N
Second Line	:
City	:	PLAIN CITY
State	:	UT
Zip	:	84404-6797
Country	:	US
Telephone Number	:	801-652-7127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	03/12/2026

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Directions to “ KIMBERLY DAVIS LCSW” Practice Location

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