Basic Information
| Provider Information | |||||||||
| NPI: | 1598991408 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | DAYTON | ||||||||
| MiddleName: | SCOTT | ||||||||
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| Credential: | NCC, LPC, QP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5151 | ||||||||
| Address2: | 2579 CHIMNEY ROCK ROAD | ||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287935151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286924289 | ||||||||
| FaxNumber: | 8286924396 | ||||||||
| Practice Location | |||||||||
| Address1: | 2579 CHIMNEY ROCK RD | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287929181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286924289 | ||||||||
| FaxNumber: | 8286924396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2009 | ||||||||
| LastUpdateDate: | 08/25/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 7397 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.