Organization
SUSAN R. DAVIS THERAPIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN ROBERTA DAVIS LCPC (PRESIDENT)
(847) 502-1007
Entity
Organization
Contact information
Practice address
2845 VALLEY VIEW RD, GURNEE, IL 60031-1041
(847) 502-1007
(815) 301-9025
Mailing address
2845 VALLEY VIEW RD, GURNEE, IL 60031-1041
(847) 502-1007
(815) 301-9025
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
222Q00000X
Developmental Therapist
—
—
251S00000X
Community/Behavioral Health Agency
180.007623
IL
252Y00000X
Early Intervention Provider Agency
Primary
180.007623
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180.007623
ILLINOIS DEPT OF PROFESSIONAL AND FINANCIAL LICENSES
IL
01
—
SS12630298P
ILLINOIS EARLY INTERVENTION
IL
Enumeration date
07/17/2012
Last updated
03/12/2025
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