Provider Demographics
NPI:1083702054
Name:DAVIS, DOYLE HENRY II (LPC)
Entity Type:Individual
Prefix:MR
First Name:DOYLE
Middle Name:HENRY
Last Name:DAVIS
Suffix:II
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14405 OLD RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72142-9118
Mailing Address - Country:US
Mailing Address - Phone:501-961-9403
Mailing Address - Fax:
Practice Address - Street 1:14405 OLD RIVER DR
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:AR
Practice Address - Zip Code:72142-9118
Practice Address - Country:US
Practice Address - Phone:501-961-9403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP9512041101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional