Active NPI
Glacia Ethridge Davis, LCMHC, LPC, CRC, NCC
- Mental Health Counselor
- North Charleston, SC
National Provider Identifier
1447869763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 15500
- Practice address
- 6650 Rivers Ave Ste 100
North Charleston, SC 29406-4809 - Phone
- (803) 606-9932
- NPI assigned
- Jul 23, 2020
- Last updated
- Apr 28, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 10865 | SC | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 24415 | NC | |
| Mental Health Counselor | 101YM0800X | 15500 | NC | Primary |
Addresses
Primary practice location
6650 Rivers Ave Ste 100
North Charleston, SC 29406-4809
Mailing address
224 Fox Run Dr
Hopkins, SC 29061-8662
Phone (803) 606-9932
Other practice location 1
4030 Wake Forest Rd Ste 349
Raleigh, NC 27609-0010
Phone (803) 606-9932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15500 | NC | MD | Mental Health Counselor |
| 24415 | NC | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777334400000",
"number": "1447869763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 FOX RUN DR",
"city": "HOPKINS",
"state": "SC",
"postal_code": "290618662",
"telephone_number": "803-606-9932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6650 RIVERS AVE STE 100",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294064809",
"telephone_number": "803-606-9932"
}
],
"practiceLocations": [
{
"address_1": "4030 Wake Forest Rd Ste 349",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276090010",
"country_code": "US",
"telephone_number": "803-606-9932",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "GLACIA",
"middle_name": "ETHRIDGE",
"name_prefix": "Dr.",
"credential": "LCMHC, LPC, CRC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-23",
"last_updated": "2026-04-28",
"certification_date": "2026-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "SC",
"license": "10865",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "24415",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "15500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in North Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.