Healthcare Provider Details

I. General information

NPI: 1619466521
Provider Name (Legal Business Name): LAQUONNE DEE DAVIS LCPC, CACAD, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DEE DAVIS LCPC, CACAD, NCC

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1447 YORK RD STE 408
LUTHERVILLE TIMONIUM MD
21093-6084
US

IV. Provider business mailing address

3903 PRIMROSE AVE
BALTIMORE MD
21215-3519
US

V. Phone/Fax

Practice location:
  • Phone: 888-331-5251
  • Fax:
Mailing address:
  • Phone: 410-908-4473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC8526
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: