Provider Demographics
NPI:1215820055
Name:DAVIS, YANCY (D MIN)
Entity type:Individual
Prefix:DR
First Name:YANCY
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 FLORA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64109-2709
Mailing Address - Country:US
Mailing Address - Phone:816-200-1090
Mailing Address - Fax:
Practice Address - Street 1:3725 FLORA AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64109-2709
Practice Address - Country:US
Practice Address - Phone:816-200-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS175T00000X
GA101YP1600X
171M00000X
MO172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver