Provider Demographics
NPI:1730312331
Name:DAVIS, YOLANDA KAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5611 BERRY CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-1468
Mailing Address - Country:US
Mailing Address - Phone:919-803-1841
Mailing Address - Fax:
Practice Address - Street 1:5611 BERRY CREEK CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1468
Practice Address - Country:US
Practice Address - Phone:919-803-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-29
Last Update Date:2009-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0063971041C0700X
MI68010688301041C0700X
NC000061041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool