Provider Demographics
NPI:1376754275
Name:DAVIS, NANCY ELIZABETH (LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELIZABETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 AVENUE N 1/2
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-1837
Mailing Address - Country:US
Mailing Address - Phone:409-763-2613
Mailing Address - Fax:409-763-2613
Practice Address - Street 1:5024 AVE. N AND A HALF
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-1837
Practice Address - Country:US
Practice Address - Phone:409-763-2613
Practice Address - Fax:409-763-2613
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9178101YM0800X
TX1490106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9178Medicare ID - Type UnspecifiedLPC
TX1492Medicare ID - Type UnspecifiedLMFT