Provider Demographics
NPI:1255104048
Name:DAVIS, CATHERINE LUCY (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:LUCY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3114 QUARTZ WAY
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-9287
Mailing Address - Country:US
Mailing Address - Phone:706-496-6819
Mailing Address - Fax:
Practice Address - Street 1:997 ST. SEBASTIAN WAY
Practice Address - Street 2:PSYCHIATRY AND HEALTH BEHAVIOR
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912
Practice Address - Country:US
Practice Address - Phone:706-721-6597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6024103TH0004X
GAPS-T001135103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth