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General NPI Number Information
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NPI Number | 1982004123
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Entity Type | Individual
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Provider Name | BRIAN S DAVIES LCPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 1529 BELMONT ST.
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City | BOISE
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State | ID
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Zip | 83706
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Country | US
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Telephone | 208-391-5225
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Fax |
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Provider Business Mailing Address
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Address Line | 1124 W FORT ST APT. 3
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City | BOISE
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State | ID
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Zip | 83702-5374
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Country | US
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Telephone | 208-850-9696
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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 | 7619
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License Number State | ID
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