Provider Demographics
NPI:1619608270
Name:DAVIS, CAMERON (MSSW)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 SPANISH MOSS WAY APT A10
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-6737
Mailing Address - Country:US
Mailing Address - Phone:931-434-4719
Mailing Address - Fax:
Practice Address - Street 1:4409 CENTRAL AVENUE PIKE # 102103
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-4081
Practice Address - Country:US
Practice Address - Phone:865-500-5286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health