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General NPI Number Information
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NPI Number | 1508060005
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Entity Type | Individual
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Provider Name | KAREN R DAVIS M.A., L.P.A.
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Gender | Female
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 3491 EVANS ST SUITE A
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City | GREENVILLE
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State | NC
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Zip | 27834-4534
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Country | US
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Telephone | 252-349-5838
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Fax | 252-364-2231
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Provider Business Mailing Address
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Address Line | 2163 PRESTON TRAILS DR
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City | WINTERVILLE
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State | NC
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Zip | 28590-7047
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Country | US
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Telephone | 252-349-5838
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3395
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-A 20839
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License Number State | NC
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