Individual
CAROL ANN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW CP
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
Update your record
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