Provider Demographics
NPI:1932890258
Name:DAVIS, WHITNEY JANE (LADC)
Entity Type:Individual
Prefix:MISS
First Name:WHITNEY
Middle Name:JANE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MAIN ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-3170
Mailing Address - Country:US
Mailing Address - Phone:603-717-6488
Mailing Address - Fax:603-676-7537
Practice Address - Street 1:202 MAIN ST STE 104
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-3170
Practice Address - Country:US
Practice Address - Phone:603-717-6488
Practice Address - Fax:603-676-7537
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1222101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)