Provider Demographics
NPI:1043510951
Name:DAVIS, EUGENIA VALISHA (LPC, LCAS)
Entity type:Individual
Prefix:MS
First Name:EUGENIA
Middle Name:VALISHA
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10587 DOUBLE R BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8966
Mailing Address - Country:US
Mailing Address - Phone:954-684-1349
Mailing Address - Fax:775-384-2336
Practice Address - Street 1:3762 MARSHLANE WAY
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:954-684-1349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-26
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2998101YA0400X
NC9235101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
101YM0800XOtherDIGI PSYCHOTHERAPY SERVICES, INC.