Healthcare Provider Details

I. General information

NPI: 1619691458
Provider Name (Legal Business Name): ANAYA DENISE DAVIS MA, NCC, LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6115 PARK SOUTH DR
CHARLOTTE NC
28210-3269
US

IV. Provider business mailing address

111 MACKENAN DR
CARY NC
27511-7903
US

V. Phone/Fax

Practice location:
  • Phone: 980-351-1527
  • Fax:
Mailing address:
  • Phone: 919-371-2848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23135
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: