Provider Demographics
NPI:1881020790
Name:DAVIS, CHARISSA CARON (MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:CHARISSA
Middle Name:CARON
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:CHARISSA
Other - Middle Name:
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10101 HARWIN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1687
Mailing Address - Country:US
Mailing Address - Phone:832-786-1180
Mailing Address - Fax:
Practice Address - Street 1:10101 HARWIN DR STE 302
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1692
Practice Address - Country:US
Practice Address - Phone:832-786-1180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional