Provider Demographics
NPI:1447036736
Name:DAVIS KEITT, TEREASH CELESTE (LPCA)
Entity type:Individual
Prefix:MRS
First Name:TEREASH
Middle Name:CELESTE
Last Name:DAVIS KEITT
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2235 LAKE MURRAY BLVD APT 2103
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1058
Mailing Address - Country:US
Mailing Address - Phone:803-707-8552
Mailing Address - Fax:
Practice Address - Street 1:2235 LAKE MURRAY BLVD APT 2103
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1058
Practice Address - Country:US
Practice Address - Phone:803-707-8552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-04
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8748101YP2500X
SC8784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional