Provider Demographics
NPI:1881928026
Name:DAVIS, FELICIA RENEE (LLMSW)
Entity type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:RENEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23210 MIDDLEBELT RD
Mailing Address - Street 2:202
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-3696
Mailing Address - Country:US
Mailing Address - Phone:248-837-5318
Mailing Address - Fax:248-987-4460
Practice Address - Street 1:23210 MIDDLEBELT RD
Practice Address - Street 2:202
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-3696
Practice Address - Country:US
Practice Address - Phone:248-837-5318
Practice Address - Fax:248-987-4460
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801091498104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker