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General NPI Number Information
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NPI Number | 1649204827
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Entity Type | Organization
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Legal Business Name | MARK DAVIS, LMHP, LPC, INC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4830 S 69TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-1501
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Country | US
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Telephone | 402-440-7884
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Fax |
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Provider Business Mailing Address
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Address Line | 4830 S 69TH ST
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City | LINCOLN
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State | NE
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Zip | 68516-1501
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Country | US
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Telephone | 402-440-7884
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK DAVIS
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Credential | LMHP, LPC
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Telephone | 402-440-7884
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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 | 1302
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License Number State | NE
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