Provider Demographics
NPI:1649309782
Name:DAVIES, KAY LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:LYNN
Last Name:DAVIES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 SNOWSHOE LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6431
Mailing Address - Country:US
Mailing Address - Phone:775-830-0494
Mailing Address - Fax:775-337-4565
Practice Address - Street 1:4465 BOCA WAY
Practice Address - Street 2:SPC 146
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6438
Practice Address - Country:US
Practice Address - Phone:775-830-0494
Practice Address - Fax:775-376-8549
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3035-C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509077Medicaid