Provider Demographics
NPI:1871372961
Name:DAVIS, MEGAN MAIRE
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MAIRE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:MAIRE
Other - Last Name:HORCASITAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AMFT
Mailing Address - Street 1:1538 MEADOW BROOKE PL
Mailing Address - Street 2:
Mailing Address - City:MCKINLEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95519-4287
Mailing Address - Country:US
Mailing Address - Phone:707-798-7669
Mailing Address - Fax:
Practice Address - Street 1:791 8TH ST STE S
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6234
Practice Address - Country:US
Practice Address - Phone:707-798-7669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141266101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health