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General NPI Number Information
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NPI Number | 1457527673
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Entity Type | Individual
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Provider Name | CAROL ANN DAVIS LISW CP
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Gender | Female
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 104 MAXWELL AVE SUITE 227
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City | GREENWOOD
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State | SC
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Zip | 29646-2641
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Country | US
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Telephone | 864-396-2810
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Fax | 864-396-2810
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Provider Business Mailing Address
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Address Line | PO BOX 51573
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City | GREENWOOD
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State | SC
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Zip | 29649-0043
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Country | US
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Telephone | 864-396-2810
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Fax | 864-396-2810
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1309
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C006125
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9701
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License Number State | SC
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