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NPI Code Detail

MEDICARE: ELISKA DAVIS COUNCE NCC, LPC-S

MEDICARE: ELISKA DAVIS COUNCE NCC, LPC-S
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
1101YM0800XMental Health Counselor18489TX

General Provider Information

NPI Number : 1770678278
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISKA DAVIS COUNCE NCC, LPC-S
Provider Business Mailing Address
First Line : 1515 HERITAGE DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-3256
Country : US
Telephone Number : 469-966-5189
Fax Number :
Provider Business Practice Location Address
First Line : 1515 HERITAGE DR
Second Line :
City : MCKINNEY
State : TX
Zip : 75069-3256
Country : US
Telephone Number : 469-966-5189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 03/19/2026

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