Healthcare Provider Details

I. General information

NPI: 1790603405
Provider Name (Legal Business Name): KELSEY RAYE DAVIS LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1201 N ROXBORO ST
DURHAM NC
27701-2354
US

IV. Provider business mailing address

3125 POPLARWOOD CT STE 203
RALEIGH NC
27604-6445
US

V. Phone/Fax

Practice location:
  • Phone: 984-263-8887
  • Fax:
Mailing address:
  • Phone: 919-787-6131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023960
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: