Provider Demographics
NPI:1184279002
Name:DAVIS, DAZZMEN N (LCMHC, LPC)
Entity type:Individual
Prefix:
First Name:DAZZMEN
Middle Name:N
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 FOOTBRIDGE LN
Mailing Address - Street 2:STE 124 #524
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306
Mailing Address - Country:US
Mailing Address - Phone:404-649-5274
Mailing Address - Fax:
Practice Address - Street 1:3350 FOOTBRIDGE LN
Practice Address - Street 2:STE 124 #524
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306
Practice Address - Country:US
Practice Address - Phone:404-649-5274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15072101YP2500X
NCA15072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional