Active NPI
Helen Marion Davis, LCSW
- Clinical Social Worker
- Boulder, CO
National Provider Identifier
1053074435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 00992092
- Practice address
- 612 Inca Pkwy
Boulder, CO 80303-3523 - Phone
- (303) 543-9710
- NPI assigned
- Oct 21, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 00992092 | CO | Primary |
Addresses
Primary practice location
612 Inca Pkwy
Boulder, CO 80303-3523
Mailing address
612 Inca Pkwy
Boulder, CO 80303-3523
Phone (303) 543-9710
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00992092 | CO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1053074435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 INCA PKWY",
"city": "BOULDER",
"state": "CO",
"postal_code": "803033523",
"telephone_number": "303-543-9710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 INCA PKWY",
"city": "BOULDER",
"state": "CO",
"postal_code": "803033523",
"telephone_number": "303-543-9710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "HELEN",
"middle_name": "MARION",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-21",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "00992092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.