Provider Demographics
NPI:1467641654
Name:DAVIS, KARLEE (LGSW)
Entity Type:Individual
Prefix:
First Name:KARLEE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 WHEATLAND ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25405-0040
Mailing Address - Country:US
Mailing Address - Phone:304-267-0818
Mailing Address - Fax:
Practice Address - Street 1:63 WHEATLAND ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-0040
Practice Address - Country:US
Practice Address - Phone:304-267-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker