Provider Demographics
NPI:1831334358
Name:DAVIS, FEONA I (LCPC)
Entity type:Individual
Prefix:MS
First Name:FEONA
Middle Name:I
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8603 JACKS REEF RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1713
Mailing Address - Country:US
Mailing Address - Phone:301-672-6784
Mailing Address - Fax:
Practice Address - Street 1:501 HIGHLAND STREET
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702
Practice Address - Country:US
Practice Address - Phone:301-668-1689
Practice Address - Fax:301-668-1901
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional