Provider Demographics
NPI:1821522145
Name:DAVIS, MEGAN (BSW, CSAC-I)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:BSW, CSAC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E SIX FORKS RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7745
Mailing Address - Country:US
Mailing Address - Phone:919-803-8838
Mailing Address - Fax:
Practice Address - Street 1:211 E SIX FORKS RD
Practice Address - Street 2:SUITE 117
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7745
Practice Address - Country:US
Practice Address - Phone:919-803-8838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)