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General NPI Number Information
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NPI Number | 1396565198
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Entity Type | Individual
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Provider Name | DANIELLE N DAVISCOURT AMFT, APCC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 673 S AUBURN ST
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City | GRASS VALLEY
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State | CA
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Zip | 95945-7576
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Country | US
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Telephone | 530-913-7221
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Fax |
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Provider Business Mailing Address
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Address Line | 17995 LAKE FOREST DR
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City | PENN VALLEY
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State | CA
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Zip | 95946-8822
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Country | US
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Telephone | 209-401-4145
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 16663
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 146952
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License Number State | CA
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