Provider Demographics
NPI:1184013898
Name:DAVIS, SHNIKA
Entity Type:Individual
Prefix:
First Name:SHNIKA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 GODWIN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-4207
Mailing Address - Country:US
Mailing Address - Phone:910-876-0251
Mailing Address - Fax:910-608-2225
Practice Address - Street 1:1603 GODWIN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-4207
Practice Address - Country:US
Practice Address - Phone:910-876-0251
Practice Address - Fax:910-608-2225
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0091771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical