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General NPI Number Information
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NPI Number | 1437717410
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Entity Type | Individual
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Provider Name | OKICHIE M DAVIS LPC, LCPC, ACS, NCC
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Gender | Female
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 1315 SPRUCE ST STE 222
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City | PHILADELPHIA
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State | PA
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Zip | 19107-4701
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Country | US
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Telephone | 215-469-1356
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Fax |
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Provider Business Mailing Address
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Address Line | 4640 E ROOSEVELT BLVD STE 3 #1476
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City | PHILADELPHIA
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State | PA
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Zip | 19124-2300
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Country | US
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Telephone | 215-469-1356
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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 | PC011190
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License Number State | PA
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