MEDICARE: MR. DEMETRICK LEWAYNE DAVIS SR.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12345678	OTHER	OK	OKLAHOMA DEPT. OF MENTAL HEALTH

General Provider Information

NPI Number	:	1659632503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DEMETRICK LEWAYNE DAVIS SR.

Provider Business Mailing Address
First Line	:	3208 N.E. OVERBROOK DR.
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73121
Country	:	US
Telephone Number	:	405-885-3651
Fax Number	:

Provider Business Practice Location Address
First Line	:	3208 NE OVERBROOK DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73121-2853
Country	:	US
Telephone Number	:	405-885-3651
Fax Number	:

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

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	06/06/2012

Similar Medicare Providers

1013102102 — MR. TERRY DOUGLAS MASTERS MSW-LCSW
Practice Location Address:

2853 NW 20TH ST
OKLAHOMA CITY, OK
73107-3103

Practice Phone: 405-943-9143
Practice Fax:

1770753378 — MS. GIGI K. SILVERHORN LPC
Practice Location Address:

3824 N MERIDIAN AVE , SUITE 102
OKLAHOMA CITY, OK
73112-2853

Practice Phone: 405-637-8000
Practice Fax:

1205087236 — FAMILY FOCUS COUNSELING SERVICES, LLC
Practice Location Address:

3824 N MERIDIAN AVE , SUITE 104
OKLAHOMA CITY, OK
73112-2853

Practice Phone: 405-602-0835
Practice Fax: 405-602-0936

1912231754 — CORNERSTONE HOME HEALTH SERVICES
Practice Location Address:

3824 N MERIDIAN AVE , SUITE 102
OKLAHOMA CITY, OK
73112-2853

Practice Phone: 405-354-5454
Practice Fax: 405-942-1555

1932427614 — KAMI EVE ROBINSON
Practice Location Address:

3824 N MERIDIAN AVE , SUITE 104
OKLAHOMA CITY, OK
73112-2853

Practice Phone: 405-602-0835
Practice Fax:

1942528625 — EMILY DIANE SCHANTZ
Practice Location Address:

3824 N MERIDIAN AVE , SUITE 104
OKLAHOMA CITY, OK
73112-2853

Practice Phone: 405-602-0835
Practice Fax: 405-602-0936

Directions to “ MR. DEMETRICK LEWAYNE DAVIS SR. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.