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NPI Code Detail

MEDICARE: MS. ENAUSA DAVIS HENDLEY LPC, BCPCC

MEDICARE:  MS. ENAUSA DAVIS HENDLEY  LPC, BCPCC
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
1101Y00000XCounselor7648NC

General Provider Information

NPI Number : 1619245594
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ENAUSA DAVIS HENDLEY LPC, BCPCC
Provider Business Mailing Address
First Line : 705 CUMBERLAND ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-7020
Country : US
Telephone Number : 404-593-5391
Fax Number :
Provider Business Practice Location Address
First Line : 705 CUMBERLAND ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-7020
Country : US
Telephone Number : 910-483-5986
Fax Number : 910-483-2876
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2011
Last Update Date : 03/13/2019

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