Provider Demographics
NPI:1427266154
Name:DAVIS, SHELBY ALEXIS (LPC)
Entity type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:ALEXIS
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4790 JETT RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4566
Mailing Address - Country:US
Mailing Address - Phone:954-401-4357
Mailing Address - Fax:
Practice Address - Street 1:1640 POWERS FERRY RD
Practice Address - Street 2:BUILDING 2, SUITE 150
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-5491
Practice Address - Country:US
Practice Address - Phone:954-401-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004341174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist