Stephen Mark Davis | Philadelphia, PA • PECOS Search

Stephen Mark Davis

Counselor

Behavioral Health & Social Service Providers

112 N Broad St, Philadelphia, PA 19102-1512

PECOS Enrollment

Based on the most recent information from CMS, provider Stephen Mark Davis does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1659843233
Provider Type
Individual
Full Name
Davis, Stephen Mark
Gender
Male

Sole Proprietor
No
Enumeration Date
12/20/2018
Last Updated
12/20/2018

Contact Information

Practice Location

112 N Broad St, Philadelphia, PA 19102-1512

Unlisted Fax

Mailing Location

112 N Broad St, Philadelphia, PA 19102-1512

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YA0400X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer