Provider Demographics
NPI:1013200070
Name:DAVIS, ANNA CHRISTINA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:CHRISTINA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 CORONATION DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-2611
Mailing Address - Country:US
Mailing Address - Phone:770-833-9052
Mailing Address - Fax:404-292-3848
Practice Address - Street 1:465 WINN WAY
Practice Address - Street 2:SUITE 221
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1753
Practice Address - Country:US
Practice Address - Phone:404-292-3810
Practice Address - Fax:404-292-3848
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC 004717101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional