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NPI Code Detail

MEDICARE: MRS. BRENDA L DAVIS MA, LPC

MEDICARE: MRS. BRENDA L DAVIS MA, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor0701003883VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144371857
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA L DAVIS MA, LPC
Provider Business Mailing Address
First Line : 2713 DEERFIELD CRES
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23321-2447
Country : US
Telephone Number : 757-373-4232
Fax Number : 757-956-6101
Provider Business Practice Location Address
First Line : 3217 WESTERN BRANCH BLVD.
Second Line : SUITES C AND D
City : CHESAPEAKE
State : VA
Zip : 23321-5235
Country : US
Telephone Number : 757-956-6100
Fax Number : 757-956-6101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 11/19/2019

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