Provider Demographics
NPI:1528082351
Name:BROWN-DAVIS, TANYA LANETTE (MS, LPC)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:LANETTE
Last Name:BROWN-DAVIS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-0211
Mailing Address - Country:US
Mailing Address - Phone:469-525-2498
Mailing Address - Fax:469-277-1934
Practice Address - Street 1:211 N FANNIN AVE
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-3118
Practice Address - Country:US
Practice Address - Phone:469-525-2498
Practice Address - Fax:469-277-1934
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16222101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0289589-06Medicaid
TX6675LCOtherBLUE CROSS
TX0289589-07Medicaid