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Individual
DR. GLACIA ETHRIDGE DAVIS
Active
Individual
DR. GLACIA ETHRIDGE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC, LPC, CRC, NCC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
10865
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
24415
NC
101YM0800X
Mental Health Counselor
Primary
15500
NC
101YM0800X
Mental Health Counselor
Primary
A15500
NC
Other
Enumeration date
07/23/2020
Last updated
04/28/2026
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