Provider Demographics
NPI:1295988392
Name:DAVIS, NANCY WHITFORD (LPC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:WHITFORD
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 HITCHING POST LN
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-5858
Mailing Address - Country:US
Mailing Address - Phone:843-902-9357
Mailing Address - Fax:
Practice Address - Street 1:4402 HITCHING POST LN
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5858
Practice Address - Country:US
Practice Address - Phone:843-902-9357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3985101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCLICENSE NUMBER 3985OtherSC DEPT. OF LABOR, LICENSING AND REGULATION, PROFESSIONAL COUNSELORS