Healthcare Provider Details

I. General information

NPI: 1982900593
Provider Name (Legal Business Name): STACY TEMPLETON DAVIS PSYD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W PINHOOK RD STE 504
LAFAYETTE LA
70508-3212
US

IV. Provider business mailing address

2020 W PINHOOK RD STE 504
LAFAYETTE LA
70508-3212
US

V. Phone/Fax

Practice location:
  • Phone: 337-593-0830
  • Fax:
Mailing address:
  • Phone: 337-593-0830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. STACY TEMPLETON DAVIS
Title or Position: OWNER
Credential: PSYD, MP
Phone: 337-593-0830