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MIKOL S DAVIS CHILD & FAMILY COUNSELING A PROF CORP
NPI 1033412853
Psychologist - Clinical in San Rafael, CA

Active since December 16, 2010
1703 5TH AVE STE 101, SAN RAFAEL, CA 94901(415) 459-1203(415) 459-3682 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mikol S Davis Child & Family Counseling A Prof Corp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIKOL S DAVIS CHILD & FAMILY COUNSELING A PROF CORP (NPI 1033412853) is a healthcare organization registered as a clinical in San Rafael, California and active in the NPI registry since December 2010. The organization lists Mikol S. Davis, President, as its authorized official.

NPPES Registry Identity

NPI1033412853
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameMIKOL S DAVIS CHILD & FAMILY COUNSELING A PROF CORP
Location Address1703 5TH AVE STE 101San Rafael, CA 94901-1853
Mailing Address1703 5th Ave Ste 101San Rafael, CA 94901-1853 · (415) 459-1203
Phone(415) 459-1203
Fax(415) 459-3682
Organization SubpartNo
Authorized OfficialMikol S. DavisPresident · (415) 459-1203
Enumeration DateDecember 16, 2010
Last NPPES UpdateNovember 21, 2025
NPPES CertifiedNovember 21, 2025
✔ NPI 1033412853 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in CA · 00PL90630
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1703 5TH AVE STE 101, San Rafael, CA 94901
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mikol S Davis Child & Family Counseling A Prof Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mikol S Davis Child & Family Counseling A Prof Corp, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mikol Davis, ED.D.
Clinical Psychologist
NPI 1073525895
930 IRWIN ST SUITE 215
San Rafael, CA 94901
(415) 459-1203
✔ PECOS✔ Accepts Medicare1.0 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mikol S Davis Child & Family Counseling A Prof Corp's NPI number?

The NPI number for Mikol S Davis Child & Family Counseling A Prof Corp is 1033412853. It was assigned to this organization in the NPPES registry on December 16, 2010.

Where is Mikol S Davis Child & Family Counseling A Prof Corp located?

Mikol S Davis Child & Family Counseling A Prof Corp is located at 1703 5th Ave Ste 101, San Rafael, CA 94901. The listed phone number is (415) 459-1203.

What is Mikol S Davis Child & Family Counseling A Prof Corp's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mikol S Davis Child & Family Counseling A Prof Corp enrolled in Medicare?

Yes. Mikol S Davis Child & Family Counseling A Prof Corp is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mikol S Davis Child & Family Counseling A Prof Corp?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Mikol S Davis Child & Family Counseling A Prof Corp. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Mikol S Davis Child & Family Counseling A Prof Corp was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.