MEDICARE: BRIANNA DAVIS 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	85884	TX
2	101YP2500X	Professional Counselor	85884	TX

General Provider Information

NPI Number	:	1912745266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA DAVIS LPC

Provider Business Mailing Address
First Line	:	2112 SW H K DODGEN LOOP STE 183
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76504-7014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2112 SW H K DODGEN LOOP STE 183
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76504-7014
Country	:	US
Telephone Number	:	254-371-9319
Fax Number	:

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

Provider Enumeration Date	:	07/19/2024
Last Update Date	:	10/09/2025

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