Healthcare Provider Details

I. General information

NPI: 1215855341
Provider Name (Legal Business Name): MAKAYLA DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 12TH ST STE 613
COLUMBUS GA
31901-2482
US

IV. Provider business mailing address

233 12TH ST STE 613
COLUMBUS GA
31901-2482
US

V. Phone/Fax

Practice location:
  • Phone: 706-780-1129
  • Fax: 706-641-2057
Mailing address:
  • Phone: 706-780-1129
  • Fax: 706-641-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number011187
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: