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General NPI Number Information
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NPI Number | 1154680346
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Entity Type | Organization
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Legal Business Name | WAYNE E. DAVIDSON, LMHC
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 12/22/2024
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Provider Practice Location Address
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Address Line | 14921 W HARDY DR
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City | TAMPA
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State | FL
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Zip | 33613-1546
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Country | US
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Telephone | 813-979-0535
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Fax | 813-304-0088
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Provider Business Mailing Address
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Address Line | 14921 W HARDY DR
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City | TAMPA
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State | FL
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Zip | 33613-1546
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Country | US
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Telephone | 813-979-0535
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Fax | 813-975-9769
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WAYNE EDWARD DAVIDSON
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Credential | LMHC
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Telephone | 813-979-0535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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