Provider Demographics
NPI:1558918714
Name:DAVIS, TAMIKA MARIA (MA, LPC, NCC, CCTP)
Entity Type:Individual
Prefix:MS
First Name:TAMIKA
Middle Name:MARIA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MA, LPC, NCC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MANHATTAN BLVD BLDG D
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-3583
Mailing Address - Country:US
Mailing Address - Phone:504-908-5607
Mailing Address - Fax:
Practice Address - Street 1:1901 MANHATTAN BLVD BLDG D
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-3583
Practice Address - Country:US
Practice Address - Phone:504-908-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93342101YP2500X
171M00000X, 261QM0801X, 101YA0400X
LALPC7992101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)