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General NPI Number Information
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NPI Number | 1609412006
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Entity Type | Individual
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Provider Name | CHELSEA DAVIS LPC
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Gender | Female
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Dates
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Enumeration Date | 11/20/2019
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 214 BUSH RIVER DR
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City | FARMVILLE
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State | VA
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Zip | 23901-3179
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Country | US
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Telephone | 434-392-3187
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Fax | 434-391-1238
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Provider Business Mailing Address
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Address Line | 12419 COUNTY LINE RD
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City | KEYSVILLE
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State | VA
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Zip | 23947-4415
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Country | US
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Telephone | 434-390-7383
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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 | 0701008762
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License Number State | VA
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