Provider Demographics
NPI:1750458055
Name:DAVIS, CATHY S (DCC, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:S
Last Name:DAVIS
Suffix:
Gender:F
Credentials:DCC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 381988
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75138-1988
Mailing Address - Country:US
Mailing Address - Phone:214-616-0785
Mailing Address - Fax:972-709-4756
Practice Address - Street 1:611 FLAMINGO WAY
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3830
Practice Address - Country:US
Practice Address - Phone:214-616-0785
Practice Address - Fax:972-709-4756
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19937101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health