Provider Demographics
NPI:1134874928
Name:LIZ DAVIS LPC LLC
Entity type:Organization
Organization Name:LIZ DAVIS LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-362-8657
Mailing Address - Street 1:9 HAMILTON CT APT D
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3579
Mailing Address - Country:US
Mailing Address - Phone:203-362-8657
Mailing Address - Fax:
Practice Address - Street 1:9 HAMILTON CT APT D
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3579
Practice Address - Country:US
Practice Address - Phone:203-362-8657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-20
Last Update Date:2022-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4884OtherLICENSE