=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629946629
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FLOATING FEATHER COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2025
-----------------------------------------------------
Last Update Date | 10/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1892 GREENTREE RD
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08003-2000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-202-7774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1892 GREENTREE RD
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08003-2000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-202-7774
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. LARENA DAVIS
-----------------------------------------------------
Credential | PHD, LPC, LCADC, CCS
-----------------------------------------------------
Telephone | 856-449-6050
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------