Provider Demographics
NPI:1649599747
Name:DAVIS, SHERITA FEATHERSTONE (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SHERITA
Middle Name:FEATHERSTONE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 EXECUTIVE COURT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAKE WYLIE
Mailing Address - State:SC
Mailing Address - Zip Code:29710-9338
Mailing Address - Country:US
Mailing Address - Phone:803-265-8343
Mailing Address - Fax:
Practice Address - Street 1:9 EXECUTIVE COURT
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE WYLIE
Practice Address - State:SC
Practice Address - Zip Code:29710-9338
Practice Address - Country:US
Practice Address - Phone:803-265-8343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional