MEDICARE: HEATHER DAVIDSON

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	ALC05232	AL

General Provider Information

NPI Number	:	1598650533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER DAVIDSON

Provider Business Mailing Address
First Line	:	175 EVELYN ST
Second Line	:
City	:	TRUSSVILLE
State	:	AL
Zip	:	35173-4020
Country	:	US
Telephone Number	:	423-883-1291
Fax Number	:

Provider Business Practice Location Address
First Line	:	1109 E PARK DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-2578
Country	:	US
Telephone Number	:	205-207-5688
Fax Number	:

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

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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Directions to “ HEATHER DAVIDSON ” Practice Location

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