Organization
LAURA IRENE DAVIS
Active
Other names
Conquering Walls Counseling Agency, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA I DAVIS-PERRY LISW-SUPV (FOUNDER/OWNER)
(614) 586-3830
Entity
Organization
Contact information
Practice address
6810 E MAIN ST STE 201, REYNOLDSBURG, OH 43068-2217
(614) 357-0686
(614) 725-0402
Mailing address
6810 E MAIN ST STE 201, MAILBOX #4, REYNOLDSBURG, OH 43068-2217
(614) 357-0686
(614) 725-0402
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I.1700380
LISW-SUPV
OH
Enumeration date
05/20/2020
Last updated
11/20/2024
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