Provider Demographics
NPI:1578326591
Name:DAVIS, SHIQUILLA SHENISE (LMSW)
Entity Type:Individual
Prefix:
First Name:SHIQUILLA
Middle Name:SHENISE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 REFLECTION DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-2882
Mailing Address - Country:US
Mailing Address - Phone:864-309-5547
Mailing Address - Fax:
Practice Address - Street 1:417 REFLECTION DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29625-2882
Practice Address - Country:US
Practice Address - Phone:864-309-5547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16433101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health