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Connie Kaye Davis

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as CONNIE DAVIS.

Based on the most recent information from CMS, provider Connie Kaye Davis is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1598883902
Provider Type
Individual
Full Name
Davis, Connie Kaye
Title
Ms.
Credential
BA, MHP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
3/26/2007
Last Updated
7/8/2007

Contact Information

Practice Location

807 Madison St, Oregon, IL 61061-1735

(815) 440-5895

(815) 284-6599

Mailing Location

807 Madison St, Oregon, IL 61061-1609

(815) 440-5895

(815) 284-6611

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Connie Kaye Davis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Nelson, Brittany Lee

Boyd, Kelsey

Principato, Nikki

Hermes, Anne

Fischer, Autumn

Duke, Rebecca

Hollingsworth, Seretha

Patterson, Ashley

Smith, Adam

Thomason, Jennifer Marie