Provider Demographics
NPI:1487664082
Name:DAVIS, JAMES SHERWOOD JR (MS, CAS, LMHC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SHERWOOD
Last Name:DAVIS
Suffix:JR
Gender:M
Credentials:MS, CAS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:27 LATHAM RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-3009
Mailing Address - Country:US
Mailing Address - Phone:518-786-8225
Mailing Address - Fax:888-632-3084
Practice Address - Street 1:272 MAXWELL RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-4915
Practice Address - Country:US
Practice Address - Phone:518-438-9596
Practice Address - Fax:518-438-9598
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY001187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health