Individual provider Active NPI

Patricia Harney Davis, LICSW

  • Clinical Social Worker
  • Fall River, MA
National Provider Identifier
1124275649
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000122578 Issued in MA
Practice address
888 Maple St
Fall River, MA 02720-5304
Phone
(508) 679-5913
NPI assigned
Aug 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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 000122578 MA Primary

Addresses

Primary practice location

888 Maple St
Fall River, MA 02720-5304

Mailing address

888 Maple St
Fall River, MA 02720-5304
Phone (508) 679-5913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20050111000402 MA Practitioner - Clinical Social Worker 3072561596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

888 Maple St
Fall River, MA 02720-5304
Phone (774) 294-5416

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000122578MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jarvis Family Services Inc Clinical CurrentSince Apr 1, 2020 Accepting new patients
Retina Consultants Inc PastSince Apr 1, 2020 Accepting new patients
South Bay Early Intervention Past Accepting new patients

Locations

888 Maple St
Fall River, MA 02720
Phone (508) 673-9552

Organizations & group practices 3

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": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1124275649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 MAPLE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205304",
            "telephone_number": "508-679-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 MAPLE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205304",
            "telephone_number": "508-679-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PATRICIA",
        "middle_name": "HARNEY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000122578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.