| Stacie Davis Llc | |
|
501 Cedar Rd Ste 2c Chesapeake VA 23322-5527 | |
| (757) 574-0303 | |
| (757) 574-0102 |
| Full Name | Stacie Davis Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 501 Cedar Rd Ste 2c, Chesapeake, Virginia |
| Authorized Official Name and Position | Stacie Davis (OWNER/OPERATOR) |
| Authorized Official Contact | 7575740303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacie Davis Llc 501 Cedar Rd Ste 2c Chesapeake VA 23322-5527 Ph: (757) 574-0303 | Stacie Davis Llc 501 Cedar Rd Ste 2c Chesapeake VA 23322-5527 Ph: (757) 574-0303 |
| NPI Number | 1982178257 |
|---|---|
| Provider Enumeration Date | 01/19/2019 |
| Last Update Date | 01/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982178257 | NPI | - | NPPES |
| 1790860559 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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