Individual provider Active NPI

Joel Patrick Davison, L.C.S.W.

  • Clinical Social Worker
  • Warren, PA
National Provider Identifier
1013311364
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018306 Issued in PA
Practice address
438 Pennsylvania Ave W
Warren, PA 16365-2238
Phone
(814) 230-3042
NPI assigned
Oct 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW018306 PA Primary

Addresses

Primary practice location

438 Pennsylvania Ave W
Warren, PA 16365-2238

Mailing address

438 Pennsylvania Ave W
Warren, PA 16365-2238
Phone (814) 230-3042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150203001667 PA Practitioner - Clinical Social Worker 2567787146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Counseling LLCGroup PAC ID 8527319060, 5 clinicians

Practice addresses (Care Compare)

200 W 3Rd Ave
Warren, PA 16365-2332
Phone (814) 230-3042

311 Pennsylvania Ave E
Suite R
Warren, PA 16365-2767
Phone (814) 230-3042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Counseling, LLC CurrentSince Aug 30, 2018 Accepting new patients

Locations

438 Pennsylvania Ave W
Warren, PA 16365
Phone (814) 230-3042

200 W 3rd Ave
Warren, PA 16365
Phone (814) 230-3042

436 Pennsylvania Ave W
Warren, PA 16365
Phone (412) 848-8955

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1013311364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 PENNSYLVANIA AVE W",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652238",
            "telephone_number": "814-230-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "438 PENNSYLVANIA AVE W",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163652238",
            "telephone_number": "814-230-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "JOEL",
        "middle_name": "PATRICK",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-15",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

Verify at the official NPI Registry.