1003065467 NPI number — MS. ELIZABETH J DAVIES M.S., LMHC, NBCC

Table of content: MS. ELIZABETH J DAVIES M.S., LMHC, NBCC (NPI 1003065467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003065467 NPI number — MS. ELIZABETH J DAVIES M.S., LMHC, NBCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIES
Provider First Name:
ELIZABETH
Provider Middle Name:
J
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., LMHC, NBCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003065467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5367 NW 4TH AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEERFIELD BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33064
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-571-8178
Provider Business Mailing Address Fax Number:
954-571-8178

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 NW 6TH AVENUE
Provider Second Line Business Practice Location Address:
BROWARD COUNTY HEALTH DEPT.
Provider Business Practice Location Address City Name:
POMPANO BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-788-6051
Provider Business Practice Location Address Fax Number:
954-788-6049
Provider Enumeration Date:
09/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH5296 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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