Provider Demographics
NPI:1285226415
Name:DAVIS, BRANDON CASH (LADAC II, NCAC I)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:CASH
Last Name:DAVIS
Suffix:
Gender:M
Credentials:LADAC II, NCAC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 N LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TN
Mailing Address - Zip Code:38474-1226
Mailing Address - Country:US
Mailing Address - Phone:615-767-1670
Mailing Address - Fax:
Practice Address - Street 1:604 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-3216
Practice Address - Country:US
Practice Address - Phone:615-767-1670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1134101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty