Provider Demographics
NPI:1043936883
Name:DAVIS, GERISHIA VICTORIA (LCSW)
Entity Type:Individual
Prefix:
First Name:GERISHIA
Middle Name:VICTORIA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 HARMONY PARK XING
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4475
Mailing Address - Country:US
Mailing Address - Phone:832-769-2497
Mailing Address - Fax:
Practice Address - Street 1:2625 HARMONY PARK XING
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4475
Practice Address - Country:US
Practice Address - Phone:832-324-5318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXNAOtherNA