| Terasa L. Davis, Psy.d., Pc | |
|
5690 Watermelon Rd Suite 310 Northport AL 35473-5004 | |
| (205) 391-9777 | |
| (205) 391-9766 |
| Full Name | Terasa L. Davis, Psy.d., Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5690 Watermelon Rd, Northport, Alabama |
| Authorized Official Name and Position | Terasa L Davis (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2053919777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terasa L. Davis, Psy.d., Pc 5690 Watermelon Rd Suite 310 Northport AL 35473-5004 Ph: (205) 391-9777 | Terasa L. Davis, Psy.d., Pc 5690 Watermelon Rd Suite 310 Northport AL 35473-5004 Ph: (205) 391-9777 |
| NPI Number | 1992175426 |
|---|---|
| Provider Enumeration Date | 09/27/2015 |
| Last Update Date | 09/27/2015 |
| Medicare PECOS PAC ID | 0345587994 |
|---|---|
| Medicare Enrollment ID | O20190122000255 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992175426 | NPI | - | NPPES |
| 515-23502 | Other | AL | BCBS |
| 890010770 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 906 (Alabama) | Primary |
| Provider Name | Terasa Lynn Davis |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1659333987 PECOS PAC ID: 1254236789 Enrollment ID: I20031205000729 |
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