Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith James Davis, LPC

Individual provider Professional Counselor · NPI 1134904949

Keith James Davis, LPC is a Mental Health Counselor in Moscow, Idaho. Qualified in 2023, 3 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
3
Licensed in
ID
In the registry since
2023
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

805 N Main St Ste 109
Moscow, ID 83843-8513
Phone: (208) 831-7094
Fax: (208) 418-9816
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 818 S Washington St, Moscow, ID 83843-3049 — (208) 882-8514

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 9827 (ID)

Record details

NPI number1134904949
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorYes
NPI enumeratedAugust 29, 2023
Last updated in NPPESMay 10, 2024
Certification dateMay 10, 2024
Mailing address707 Bentz St # 252, Troy, ID 83871-0015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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