MEDICARE: CHELSEY DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	175T00000X	Peer Specialist
2	101YM0800X	Mental Health Counselor
3	101Y00000X	Counselor
4	101YA0400X	Addiction (Substance Use Disorder) Counselor
5	104100000X	Social Worker

General Provider Information

NPI Number	:	1437622974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEY DAVIS

Provider Business Mailing Address
First Line	:	4485 CANAAN PLACE DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-3048
Country	:	US
Telephone Number	:	414-243-0024
Fax Number	:

Provider Business Practice Location Address
First Line	:	4485 CANAAN PLACE DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-3048
Country	:	US
Telephone Number	:	414-243-0024
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2019
Last Update Date	:	11/05/2025

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Directions to “ CHELSEY DAVIS ” Practice Location

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