Healthcare Provider Details

I. General information

NPI: 1609312685
Provider Name (Legal Business Name): NINA DAVEY LCPC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 NEWBURG AVE # 102
CATONSVILLE MD
21228-5157
US

IV. Provider business mailing address

9 NEWBURG AVE # 102
CATONSVILLE MD
21228-5157
US

V. Phone/Fax

Practice location:
  • Phone: 443-691-3204
  • Fax:
Mailing address:
  • Phone: 443-691-3204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC6206
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: