Healthcare Provider Details

I. General information

NPI: 1740109008
Provider Name (Legal Business Name): SHAWONNAH DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 BOULEVARD ST
HIGH POINT NC
27262-3802
US

IV. Provider business mailing address

902 BONNER DR
JAMESTOWN NC
27282-8948
US

V. Phone/Fax

Practice location:
  • Phone: 336-801-1188
  • Fax:
Mailing address:
  • Phone: 336-387-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: