Provider Demographics
NPI:1881575603
Name:DAVIS, ALYSSA KILENE
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KILENE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-2504
Mailing Address - Country:US
Mailing Address - Phone:337-459-6020
Mailing Address - Fax:337-363-3667
Practice Address - Street 1:414 WEST COTTON STREET
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586
Practice Address - Country:US
Practice Address - Phone:337-363-3637
Practice Address - Fax:337-363-3667
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health