Provider Demographics
NPI:1124674973
Name:DAVIS, MARISSA GREER (LCSW)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:GREER
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 CINCINNATI ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-3007
Mailing Address - Country:US
Mailing Address - Phone:318-878-6376
Mailing Address - Fax:
Practice Address - Street 1:109 ELM ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-2844
Practice Address - Country:US
Practice Address - Phone:318-878-8656
Practice Address - Fax:318-878-2831
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA128891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical