Provider Demographics
NPI:1942332127
Name:CARTER-DAVIS, MARJORIE JAYNE (ED D, LPC, CRC)
Entity Type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:JAYNE
Last Name:CARTER-DAVIS
Suffix:
Gender:F
Credentials:ED D, LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:837 PINEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9742
Mailing Address - Country:US
Mailing Address - Phone:919-554-3698
Mailing Address - Fax:919-554-3698
Practice Address - Street 1:837 PINEVIEW DR
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9742
Practice Address - Country:US
Practice Address - Phone:919-554-3698
Practice Address - Fax:919-554-3698
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5078101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor