| Kimberly Yon-davis, Lcsw, Pllc | |
|
4393 Commons Dr E Ste 201 Destin FL 32541-8482 | |
| (850) 974-8045 | |
| (850) 678-1720 |
| Full Name | Kimberly Yon-davis, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 4393 Commons Dr E Ste 201, Destin, Florida |
| Authorized Official Name and Position | Kimberly S Yon-davis (DIRECT OWNER) |
| Authorized Official Contact | 8509748045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Yon-davis, Lcsw, Pllc 1512 John Sims Pkwy E # 353 Niceville FL 32578-2143 Ph: (850) 974-8045 | Kimberly Yon-davis, Lcsw, Pllc 4393 Commons Dr E Ste 201 Destin FL 32541-8482 Ph: (850) 974-8045 |
| NPI Number | 1508232539 |
|---|---|
| Provider Enumeration Date | 08/13/2015 |
| Last Update Date | 10/13/2021 |
| Certification Date | 10/13/2021 |
| Medicare PECOS PAC ID | 3577871656 |
|---|---|
| Medicare Enrollment ID | O20151009001744 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508232539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW11761 (Florida) | Primary |
| Provider Name | Kimberly S Yon-davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992129290 PECOS PAC ID: 3971720673 Enrollment ID: I20140804000539 |
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