Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1689822686 Individual Practitioner Male Practitioner

Shane K Davis , LMHC

Psychologist - Counseling • Bradenton, FL

Professional Overview & Biography Verified Profile Summary

Shane Davis, LMHC is a registered healthcare professional specializing in Psychologist - Counseling in Bradenton, FL. Practice services are available at 5325 E STATE ROAD 64 STE B under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5325 E State Road 64 Ste B

Bradenton, FL 342085534

Telephone 9412779922
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist - Counseling in Bradenton, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.9 Yrs
Regional Practice Density
4 Specialists

Practicing in Bradenton, FL (311 Statewide)

Telehealth Adoption Rate
25.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-07-23
Psychologist - Counseling Primary Specialty

NUCC Taxonomy Code: 103TC1900X

State License MI 6361001470

A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License FL MH23035

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID License
6301013040 (MI)
Commercial Insurance / Payer ID Limited License
6361001470 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Keerthika Mathialagan , MD

Student in an Organized Health Care Education/Training Program

NPI 1457096331

Doctor of Medicine (M.D.)

Camille Markham , PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1972114023

Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
📍
Updated Practice Location July 23, 2026

Registered at 5325 E STATE ROAD 64 STE B, BRADENTON, FL 342085534 (Tel: 9412779922)

📍
Updated Business Mailing Address July 23, 2026

Registered at 5325 E STATE ROAD 64 STE B, BRADENTON, FL 342085534 (Tel: 9412779922)

👤
Provider Name / Credentials Updated July 23, 2026

Recorded as SHANE DAVIS, LMHC

👤
Provider Name / Credentials Updated January 11, 2024

Recorded as SHANE DAVIS, L.MHC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 11, 2024

Counselor (License #MH23035 in FL)

NPI Profile Active January 05, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location January 05, 2017

Registered at 4515 26TH ST W, BRADENTON, FL 342077200 (Tel: 2692824298)

📍
Updated Business Mailing Address January 05, 2017

Registered at 4515 26TH ST W, BRADENTON, FL 342077200 (Tel: 2692824298)

👤
Provider Name / Credentials Updated January 05, 2017

Recorded as SHANE DAVIS, L.L.P.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 05, 2017

Psychologist (License #6301013040 in MI)

🟢
Initial NPI Registration & Enumeration September 03, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1689822686
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 03, 2008
Last Update: July 23, 2026
Sole Proprietor: No

Mailing Address

5325 E State Road 64 Ste B

Bradenton, FL 342085534

Phone: 9412779922

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.