Provider Demographics
NPI:1093892515
Name:DAVIS, WILLIAM AUGUSTA JR (LHMC, LPC, LCDC, MAC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:AUGUSTA
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:LHMC, LPC, LCDC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BEHAVIORAL HEALTH MEDICINE-MULTI-D CLINIC, BAMC
Mailing Address - Street 2:4178 PETROLEUM DRIVE, BLDG 3528R
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:210-916-4242
Mailing Address - Fax:210-539-5467
Practice Address - Street 1:BEHAVIORAL HEALTH MEDICINE-MULTI-D CLINIC
Practice Address - Street 2:3551 ROGER BROOKE DRIVE
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-808-6460
Practice Address - Fax:210-539-9400
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75551101Y00000X
NC156855101YA0400X
TX9787101YA0400X
IL178.002744101YP2500X
WALH 60024561101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional