Provider Demographics
NPI:1255612883
Name:DAVIDSON, KARSHIBIA (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:KARSHIBIA
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:KARSHIBIA
Other - Middle Name:
Other - Last Name:LLOYD DAVIDSON TUCKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 FRANKLIN LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-6704
Mailing Address - Country:US
Mailing Address - Phone:888-788-7145
Mailing Address - Fax:888-788-1564
Practice Address - Street 1:322 FRANKLIN LAKE CIR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-6704
Practice Address - Country:US
Practice Address - Phone:888-788-7145
Practice Address - Fax:888-788-1564
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011772101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional