Provider Demographics
NPI:1730823063
Name:HORNE-DAVIS, DEANNE KIM (LPC, CAADC,CSAC)
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:KIM
Last Name:HORNE-DAVIS
Suffix:
Gender:F
Credentials:LPC, CAADC,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7316 FORT ALVIS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-6889
Mailing Address - Country:US
Mailing Address - Phone:804-363-2769
Mailing Address - Fax:
Practice Address - Street 1:7316 FORT ALVIS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-6889
Practice Address - Country:US
Practice Address - Phone:804-363-2769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011426101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional