Provider Demographics
NPI:1821357708
Name:NANCY E. DAVIE, INC.
Entity Type:Organization
Organization Name:NANCY E. DAVIE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:DAVIE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LMHC
Authorized Official - Phone:904-259-1758
Mailing Address - Street 1:PO BOX 748
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063-0748
Mailing Address - Country:US
Mailing Address - Phone:904-259-1758
Mailing Address - Fax:904-259-9553
Practice Address - Street 1:117 S 5TH ST
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063-2303
Practice Address - Country:US
Practice Address - Phone:904-259-1758
Practice Address - Fax:904-259-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3067101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
11530833OtherCAQH
133518000OtherMAGELLAN HEALTH SERVICES
Z6736OtherBC/BS
100055819OtherSOUTHCARE PPO
239885OtherAV-MED
169263OtherMANAGED HN
272031OtherVALUE OPTIONS
2016499OtherFIRST HEALTH
5378011OtherAETNA
9426111OtherPHCS
DAVNANCYOtherCORPHEALTH, INC.