Healthcare Provider Details

I. General information

NPI: 1750119053
Provider Name (Legal Business Name): JOYCELYN ELLESE DAVIS LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2218 RHODE ISLAND AVE NE
WASHINGTON DC
20018-2827
US

IV. Provider business mailing address

14022 WHEEL WRIGHT PL
ACCOKEEK MD
20607-3793
US

V. Phone/Fax

Practice location:
  • Phone: 202-526-3880
  • Fax: 202-526-3944
Mailing address:
  • Phone: 757-268-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGPC200001635
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: