Individual ProviderDavyd KazakovCounselorBehavioral Health & Social Service ProvidersPractice Address1601 E Fourth Plain Blvd, Bldg 17, Ste B222, Vancouver, WA 98661-3717(360) 558-5795(360) 909-4240PECOS EnrollmentBased on the most recent information from CMS, provider Davyd Kazakov does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 10:04 AM.Profile DetailsProvider ID1336836238Provider TypeIndividualFull NameKazakov, DavydCredentialLMHCAGenderMaleSole ProprietorNoEnumeration Date4/20/2023Last Updated2/19/2025Contact InformationPractice LocationPractice Address1601 E Fourth Plain Blvd, Bldg 17, Ste B222, Vancouver, WA 98661-3717Phone(360) 558-5795FaxUnlisted FaxMailing LocationMailing Address10618 NE 20th Ave, Vancouver, WA 98686-5688Phone(360) 909-4240FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseLH61640563Washington