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Mr. Derrick Lavel Davis SR., LPC
Mental Health Counselor in Charlotte, North Carolina
NPI 1265620611

Derrick Lavel Davis SR. is a Mental Health Counselor based in Charlotte, NC and is specialized in Mental Health. Derrick Lavel Davis SR. practices in Charlotte, NC and has the professional credentials of LPC. The NPI Number for Derrick Lavel Davis SR. is 1265620611 and holds a License No. 6103353 (North Carolina).

The current practice location address for Derrick Lavel Davis SR. is 4601 Park Rd Ste 400, Charlotte, NC and can be reached out via phone at 704-344-0491 and via fax at 704-344-0493.

Location: 4601 Park Rd Ste 400, Charlotte, NC, 28256-3328
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Provider Profile Details
NPI Number
1265620611
Provider Name
Derrick Lavel Davis SR.
Credential
LPC
Provider Entity Type
Individual
Gender
Male
Address
4601 Park Rd Ste 400, Charlotte, NC, 28256-3328
Phone Number
704-344-0491
Fax Number
704-344-0493
Provider Enumeration Date
10/11/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
6103353 05 NC
institution
Provider Business Practice Location Address Details
Address
4601 Park Rd Ste 400
City
State
Zip
28209-2284
Phone Number
704-344-0491
Fax Number
704-344-0493
person
Provider Business Mailing Address Details
Address
4601 Park Rd Ste 400
City
State
Zip
28209-2284
Phone Number
704-344-0491
Fax Number
704-344-0493
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
5084 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
6103353 (North Carolina)
Definition
Definition to come...
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