Provider Demographics
NPI:1588326789
Name:DAVIS, JOANNA (LMSW)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 CHAPEL HILL RD
Mailing Address - Street 2:2959 CHAPEL HILL RD. SUITE D #1474
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135
Mailing Address - Country:US
Mailing Address - Phone:404-620-0562
Mailing Address - Fax:
Practice Address - Street 1:2959 CHAPEL HILL RD
Practice Address - Street 2:2959 CHAPEL HILL RD. SUITE D #1474
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135
Practice Address - Country:US
Practice Address - Phone:404-620-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW010019104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker