Mary Linda Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

764-C Issued in AR

Practice address

1301 Wilson Rd
Little Rock, AR 72205-6659

Phone

(501) 225-0576

Fax

(501) 225-6789

NPI assigned

Jul 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• We Psychiatric Services PLLC

  • Psychologist
  • Little Rock, AR
  • NPI 1932174836
  Medicare reassignment
• Senior Resolution Resources, Inc

  • Mental Health Counselor
  • Little Rock, AR
  • NPI 1760453914
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623456000000",
    "number": "1154343499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 WILSON RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056659",
            "telephone_number": "501-225-0576",
            "fax_number": "501-225-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WILSON RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056659",
            "telephone_number": "501-225-0576",
            "fax_number": "501-225-6789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2001 Club Manor Dr Ste J",
            "address_purpose": "LOCATION",
            "city": "Maumelle",
            "state": "AR",
            "postal_code": "721137417",
            "country_code": "US",
            "telephone_number": "501-687-0488",
            "fax_number": "501-687-0489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARY",
        "middle_name": "LINDA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2021-06-12",
        "certification_date": "2021-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "AR",
            "license": "R13457",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "764-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "211768",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "278210000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "093594",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1054808",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lashundia Davis, RN
• Laura Celeste Davis
• Lee Ann Davis, OTRL
• Mallory Davis
• Marlene Michelle Davis, APN
• Morgan Danielle Davis, PHARMD
• Otis McKinnley Davis IV, MD
• Payton McKenzie Davis
• Peter Davis
• Rebecca Kay Davis, CCC-SLP

• Clinical Social Worker in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.