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General NPI Number Information
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NPI Number | 1699442897
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Entity Type | Organization
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Legal Business Name | DAVIDSON COUNSELING LLC
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 1412 DEAN STREET
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City | ROME
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State | GA
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Zip | 30161
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Country | US
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Telephone | 706-844-7956
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Fax |
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Provider Business Mailing Address
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Address Line | 1206 CLARIDGE DR. NE
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City | ROME
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State | GA
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Zip | 30161
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Country | US
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Telephone | 706-844-7956
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | STEPHANIE DAVIDSON
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Credential | DR.
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Telephone | 706-844-7956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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