Basic Information
| Provider Information | |||||||||
| NPI: | 1154645240 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAVIS | ||||||||
| FirstName: | NATONIA | ||||||||
| MiddleName: | SHERIE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW, MBA, CAP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4803 CREST RIDGE DR | ||||||||
| Address2: | |||||||||
| City: | EAST POINT | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303445796 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8137605810 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1670 CLAIRMONT RD | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300334004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043216111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2010 | ||||||||
| LastUpdateDate: | 12/03/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | SW 9617 | FL | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | CSW005278 | GA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.