Provider Demographics
NPI:1790800670
Name:DAVIS, CINDY BETH (MPS, LPC)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:BETH
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MPS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-2724
Mailing Address - Country:US
Mailing Address - Phone:336-263-4652
Mailing Address - Fax:
Practice Address - Street 1:20 SW COURT SQ
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:NC
Practice Address - Zip Code:27253-2847
Practice Address - Country:US
Practice Address - Phone:336-263-4652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3446101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional