Provider Demographics
NPI:1669457073
Name:DAVIS, MICHAEL STEPHEN (LPCC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEPHEN
Last Name:DAVIS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E CHURCH ST
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-3701
Mailing Address - Country:US
Mailing Address - Phone:740-266-2282
Mailing Address - Fax:
Practice Address - Street 1:500 E CHURCH ST
Practice Address - Street 2:SUITE 3B
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3701
Practice Address - Country:US
Practice Address - Phone:740-266-2282
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0000402101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor