Provider Demographics
NPI:1194017244
Name:DAVIS, LATOYA DENISE (LMHC)
Entity type:Individual
Prefix:MS
First Name:LATOYA
Middle Name:DENISE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4511 LOVELAND PASS DR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-9782
Mailing Address - Country:US
Mailing Address - Phone:904-535-1872
Mailing Address - Fax:
Practice Address - Street 1:4511 LOVELAND PASS DR W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-9782
Practice Address - Country:US
Practice Address - Phone:904-535-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23969101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)