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General NPI Number Information
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NPI Number | 1093031890
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Entity Type | Individual
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Provider Name | JAMES E DAVIS III LPCC
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Gender | Male
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Dates
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Enumeration Date | 04/19/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 825 E HIGH ST
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City | SPRINGFIELD
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State | OH
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Zip | 45505-1198
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Country | US
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Telephone | 937-323-0951
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Fax | 937-933-4050
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Provider Business Mailing Address
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Address Line | 5756 WILLOWDALE RD
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City | SPRINGFIELD
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State | OH
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Zip | 45502-8910
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Country | US
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Telephone | 937-323-0951
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Fax | 937-933-4050
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | E0000731
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | E0000731
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | E0000731
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License Number State | OH
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