Provider Demographics
NPI:1215740527
Name:DAVEY PSYCHOLOGY LLC
Entity type:Organization
Organization Name:DAVEY PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:801-493-5235
Mailing Address - Street 1:2916 MARKETPLACE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53719-5327
Mailing Address - Country:US
Mailing Address - Phone:608-608-0813
Mailing Address - Fax:
Practice Address - Street 1:2916 MARKETPLACE DR STE 208
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53719-5327
Practice Address - Country:US
Practice Address - Phone:608-608-0813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-30
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty