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Individual

CANDACE PETERSON DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
3821 FORRESTGATE DRIVE, DBA FORSYTH BEHAVIOR HEALTH, WINSTON-SALEM, NC 27103
(336) 277-1811
Mailing address
2000 FRONTIS PLAZA BLVD, SUITE 200 (FORSYTH MEDICAL GROUP), WINSTON-SALEM, NC 27103-5616
(336) 277-2435
(336) 277-9275

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
706
NC
101YM0800X
Mental Health Counselor
Primary
3871
NC

Other

Enumeration date
05/03/2007
Last updated
03/16/2015
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