Provider Demographics
NPI:1356220610
Name:DAVIS, MAHOGANY W
Entity type:Individual
Prefix:
First Name:MAHOGANY
Middle Name:W
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 JOYCLIFF TER
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31211-7720
Mailing Address - Country:US
Mailing Address - Phone:478-957-4609
Mailing Address - Fax:
Practice Address - Street 1:464 JOYCLIFF TER
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31211-7720
Practice Address - Country:US
Practice Address - Phone:478-957-4609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health