| Keith James Davis, LPC | |
|
805 N Main St Ste 109, Moscow, ID 83843-8513 | |
| (208) 831-7094 | |
| (208) 418-9816 |
| Full Name | Keith James Davis |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 3 Years |
| Location | 805 N Main St Ste 109, Moscow, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134904949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 9827 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Gritman Medical Center | Moscow, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mental Health Specialty Group Pa | 8921466228 | 726 |
| Entity Name | Gritman Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619988144 PECOS PAC ID: 8729070164 Enrollment ID: O20040402001021 |
| Entity Name | Gritman Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538634522 PECOS PAC ID: 0941545784 Enrollment ID: O20181221002296 |
| Entity Name | Mental Health Specialty Group PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801472634 PECOS PAC ID: 8921466228 Enrollment ID: O20240916003985 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith James Davis, LPC 707 Bentz St # 252, Troy, ID 83871-0015 Ph: (509) 592-0902 | Keith James Davis, LPC 805 N Main St Ste 109, Moscow, ID 83843-8513 Ph: (208) 831-7094 |
Monty D Hays, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 200 S Almon St Apt 214, Moscow, ID 83843 Phone: 208-878-2350 |
Hannah Claire Dejong, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 316 S Jefferson St, Moscow, ID 83843 Phone: 208-883-1144 |
Michelle Brunke, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 213 N Main St, Moscow, ID 83843 Phone: 208-683-8320 Fax: 208-969-8380 |
Danielle Hardy, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 424 E B St Apt B, Moscow, ID 83843 Phone: 208-816-1449 |
Tina M Overstreet, SUDP Counselor Medicare: Not Enrolled in Medicare Practice Location: 803 S Main St Ste 120, Moscow, ID 83843 Phone: 509-444-8200 |
Christine Meyer, M.S., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2320 E F St, Moscow, ID 83843 Phone: 208-310-1549 |
Ms. Andrea L Masom, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 106 E 3rd St, Suite 2b, Moscow, ID 83843 Phone: 208-882-1289 Fax: 208-882-8406 |