Provider Demographics
NPI:1073108650
Name:DAVIS, HEATHER (MCMHC, BCLC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MCMHC, BCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHADOW WOOD PARK
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3441
Mailing Address - Country:US
Mailing Address - Phone:205-206-9633
Mailing Address - Fax:
Practice Address - Street 1:100 SHADOW WOOD PARK
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3441
Practice Address - Country:US
Practice Address - Phone:205-918-6161
Practice Address - Fax:888-972-6921
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor