Provider Demographics
NPI:1801921457
Name:DAVIE, SHAMPA (LMHC)
Entity type:Individual
Prefix:
First Name:SHAMPA
Middle Name:
Last Name:DAVIE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2290 N. RONALD REAGAN BLVD, SUITE 116
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750
Mailing Address - Country:US
Mailing Address - Phone:407-215-0095
Mailing Address - Fax:407-261-0523
Practice Address - Street 1:2290 N. RONALD REAGAN BLVD, SUITE 116
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750
Practice Address - Country:US
Practice Address - Phone:407-215-0095
Practice Address - Fax:407-261-0523
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FLMH22724101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor