MEDICARE: DAVIS ABRAHAM 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
1	101YM0800X	Mental Health Counselor	2700	MS
2	101Y00000X	Counselor	2700	MS

General Provider Information

NPI Number	:	1326793654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVIS ABRAHAM LPC

Provider Business Mailing Address
First Line	:	304 ENTERPRISE DR STE A
Second Line	:
City	:	OXFORD
State	:	MS
Zip	:	38655-2762
Country	:	US
Telephone Number	:	662-638-3026
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 ENTERPRISE DR STE A
Second Line	:
City	:	OXFORD
State	:	MS
Zip	:	38655-2762
Country	:	US
Telephone Number	:	662-638-3026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	04/15/2026

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Directions to “ DAVIS ABRAHAM LPC” Practice Location

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