Provider Demographics
NPI:1477434827
Name:DAVIS, FELICIA NICOLE (LCSW)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:NICOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1727 BRAEBURN DR APT D17
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-7328
Mailing Address - Country:US
Mailing Address - Phone:540-293-3305
Mailing Address - Fax:
Practice Address - Street 1:4751 COVE RD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-1138
Practice Address - Country:US
Practice Address - Phone:540-293-3305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-11
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040179951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical