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General NPI Number Information
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NPI Number | 1598005514
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Entity Type | Organization
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Legal Business Name | DAVIS MENTAL HEALTH COUNSELING SERVICES
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 75 FOX RIDGE CT STE C
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City | DEBARY
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State | FL
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Zip | 32713-2701
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Country | US
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Telephone | 407-416-5454
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Fax | 321-275-4826
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Provider Business Mailing Address
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Address Line | 75 FOX RIDGE CT STE C
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City | DEBARY
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State | FL
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Zip | 32713-2701
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Country | US
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Telephone | 407-416-5454
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Fax | 321-275-4826
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Authorized Official
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Title or Position | LICENSED PSYCHOTHERAPIST
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Name | MS. MARIE A. DAVIS
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Credential | LMHC, NCC
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Telephone | 407-416-5454
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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 | MH6605
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License Number State | FL
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