Provider Demographics
NPI:1215774484
Name:DAVIDSON, ILAR ELIZABETH (LCSWA)
Entity type:Individual
Prefix:MRS
First Name:ILAR
Middle Name:ELIZABETH
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4293 OAKLAND DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-8410
Mailing Address - Country:US
Mailing Address - Phone:828-612-4383
Mailing Address - Fax:
Practice Address - Street 1:4090 CHAMBERS CHAPEL CIR
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-9233
Practice Address - Country:US
Practice Address - Phone:828-490-7053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0209811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty