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General NPI Number Information
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NPI Number | 1154791093
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Entity Type | Individual
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Provider Name | BARBARA DAVIS GRANT X LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 1799 STUMPF BLVD STE 6
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City | TERRYTOWN
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State | LA
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Zip | 70056-3950
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Country | US
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Telephone | 504-621-2306
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Fax |
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Provider Business Mailing Address
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Address Line | 118 ELAINE AVE
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City | HARAHAN
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State | LA
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Zip | 70123-4904
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Country | US
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Telephone | 504-858-3706
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4015
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 4015
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License Number State | LA
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