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General NPI Number Information
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NPI Number | 1740688399
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Entity Type | Organization
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Legal Business Name | DEBBIE DAVIS LMHC LLC
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 12/15/2014
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Provider Practice Location Address
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Address Line | 2457 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4066
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Country | US
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Telephone | 904-307-8123
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Fax | 904-645-5289
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Provider Business Mailing Address
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Address Line | 2457 3RD ST S
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4066
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Country | US
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Telephone | 904-307-8123
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Fax | 904-645-5289
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH DAVIS
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Credential | LMHC
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Telephone | 904-307-8123
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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 | 12512
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License Number State | FL
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