MEDICARE: DOROTHY FAUST-DAVIS

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	101Y00000X	Counselor	LPC-16958	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LPC-16958	OTHER	AZ	LICENSED PROFESSIONAL COUNSELOR

General Provider Information

NPI Number	:	1699177071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTHY FAUST-DAVIS

Provider Business Mailing Address
First Line	:	6424 E GREENWAY PKWY UNIT 150
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-2045
Country	:	US
Telephone Number	:	480-531-1076
Fax Number	:

Provider Business Practice Location Address
First Line	:	6424 E GREENWAY PARKWAY
Second Line	:	UNIT 150
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254-2045
Country	:	US
Telephone Number	:	480-531-1076
Fax Number	:

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

Provider Enumeration Date	:	09/17/2014
Last Update Date	:	07/05/2023

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Directions to “ DOROTHY FAUST-DAVIS ” Practice Location

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