KELLY SUSAN DAVIS
NPI 1093143554
Counselor - Mental Health in San Rafael, CA

Active since October 21, 2013PECOS EnrolledAccepts Medicare Assignment
900 5TH AVE, SUITE 150, SAN RAFAEL, CA 94901(415) 457-6964 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly Susan Davis NPPES

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

KELLY SUSAN DAVIS (NPI 1093143554) is an individual mental health provider in San Rafael, California and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1093143554
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKELLY SUSAN DAVIS
Location Address900 5TH AVE, SUITE 150San Rafael, CA 94901-2959
Mailing Address900 5th Ave, Suite 150San Rafael, CA 94901-2959 · (415) 457-6964
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateOctober 21, 2013
Last NPPES UpdateMarch 10, 2025
NPPES CertifiedMarch 10, 2025
NPI 1093143554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License MT5113 (FL)
900 5TH AVE, San Rafael, CA 94901

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kelly Susan Davis is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7618499195
PECOS Enrollment IDI20250313004076
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
900 5TH AVE, SUITE 150
SAN RAFAEL, CA 94901
Counselor
900 5TH AVE, SUITE 150
SAN RAFAEL, CA 94901
Marriage & Family Therapist
900 5TH AVE, SUITE 203
SAN RAFAEL, CA 94901
Specialist
900 5TH AVE, SUITE 203
SAN RAFAEL, CA 94901
Counselor (Mental Health)
900 5TH AVE, SUITE 150
SAN RAFAEL, CA 94901
Counselor
900 5TH AVE
SAN RAFAEL, CA 94901
Counselor (Mental Health)
900 5TH AVE, SUITE150
SAN RAFAEL, CA 94901
Social Worker
900 5TH AVE, SUITE 150
SAN RAFAEL, CA 94901

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 Kelly Davis's NPI number?

The NPI number for Kelly Davis is 1093143554. It was assigned to this individual provider in the NPPES registry on October 21, 2013.

Where is Kelly Davis located?

Kelly Davis practices at 900 5th Ave Suite 150, San Rafael, CA 94901. The listed phone number is (415) 457-6964.

What is Kelly Davis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kelly Davis enrolled in Medicare?

Yes. Kelly Davis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelly Davis accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Oscar Health Maintenance Organization of Florida and UnitedHealthcare list Kelly Davis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelly Davis was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.