Provider Demographics
NPI:1609312685
Name:DAVEY, NINA (LCPC, ATR-BC)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:DAVEY
Suffix:
Gender:F
Credentials:LCPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 CLARIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-4017
Mailing Address - Country:US
Mailing Address - Phone:443-691-3204
Mailing Address - Fax:
Practice Address - Street 1:1607 CLARIDGE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-4017
Practice Address - Country:US
Practice Address - Phone:443-691-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health