Individual
DR. TERESA M DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDD, LMHC, LPC, CSAC
Contact information
Practice address
18626 IBSEN RD, SPARTA, WI 54656-3760
(608) 487-1894
Mailing address
18626 IBSEN RD, SPARTA, WI 54656-3760
(608) 487-1894
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15452
WI
101YM0800X
Mental Health Counselor
Primary
6160-125
WI
101YM0800X
Mental Health Counselor
LH61165123
WA
Other
Enumeration date
07/21/2010
Last updated
09/26/2025
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