Provider Demographics
NPI:1104825868
Name:DAVIS, HARVEY ALLEN (LCSW)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:ALLEN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 GREENHOUSE RD
Mailing Address - Street 2:ATTN: STEPHANIE RHODENIZER
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3717
Mailing Address - Country:US
Mailing Address - Phone:540-464-3395
Mailing Address - Fax:540-464-4051
Practice Address - Street 1:315 MYERS ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2040
Practice Address - Country:US
Practice Address - Phone:540-463-3141
Practice Address - Fax:540-463-9662
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710000295101YA0400X
VA09040037771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
S96547Medicare UPIN