Individual
PHYLLIS ERICSON-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
101 SEATTLE SLEW LN, GREENVILLE, SC 29617-7901
(864) 449-4867
Mailing address
101 SEATTLE SLEW LN, GREENVILLE, SC 29617-7901
(864) 449-4867
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
#75132117
WA
101YP2500X
Professional Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TF0200X
Forensic Psychologist
—
—
103TH0100X
Health Service Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP0814X
Psychoanalysis Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TS0200X
School Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
11/17/2014
Last updated
11/19/2014
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