Provider Demographics
NPI:1235563800
Name:DAVIS, WILLIAM SHUFORD (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SHUFORD
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:SHUFORD
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1804 MICCOSUKEE CMNS # DE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5470
Mailing Address - Country:US
Mailing Address - Phone:850-385-8007
Mailing Address - Fax:
Practice Address - Street 1:1804 MICCOSUKEE COMMONS DR
Practice Address - Street 2:SUITE 204
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5470
Practice Address - Country:US
Practice Address - Phone:850-385-8007
Practice Address - Fax:850-383-9993
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT0000920103TC1900X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling