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Individual

CAROL ANN DAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW CP

Contact information

Practice address
104 MAXWELL AVE, SUITE 227, GREENWOOD, SC 29646-2641
(864) 396-2810
(864) 396-2810
Mailing address
PO BOX 51573, GREENWOOD, SC 29649-0043
(864) 396-2810
(864) 396-2810

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1309
NC
1041C0700X
Clinical Social Worker
Primary
9701
SC
1041C0700X
Clinical Social Worker
C006125
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10751529
CAQH
VA
05
6008307
NC
Enumeration date
05/07/2008
Last updated
11/23/2016
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