Active NPI
Trina Bernnadette Davis, LCSW
- Clinical Social Worker
- Richmond, VA
National Provider Identifier
1174959969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904008281
- Practice address
- 2314 4TH Ave
Richmond, VA 23222-4708 - Phone
- (804) 901-6928
- Fax
- (804) 414-7733
- NPI assigned
- Sep 24, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16-703 | MD | |
| Clinical Social Worker | 1041C0700X | 6602 | TN | |
| Clinical Social Worker | 1041C0700X | TPSW1435 | FL | |
| Clinical Social Worker | 1041C0700X | 0904008281 | VA | Primary |
Addresses
Primary practice location
2314 4TH Ave
Richmond, VA 23222-4708
Mailing address
755 Saint Andrews Drive
Apt 14-101
Murfreesboro, TN 37128
Phone (804) 901-6928
Other names 1
- Ms. Trina B. Davis-Fortune
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 |
|---|---|---|---|
| TPSW1435 | FL | MD | Clinical Social Worker |
| 16-703 | MD | MD | Clinical Social Worker |
| 0904008281 | VA | MD | Clinical Social Worker |
| 6602 | TN | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1174959969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 SAINT ANDREWS DRIVE",
"address_2": "APT 14-101",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "37128",
"telephone_number": "804-901-6928",
"fax_number": "804-414-7733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2314 4TH AVE",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232224708",
"telephone_number": "804-901-6928",
"fax_number": "804-414-7733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TRINA",
"middle_name": "BERNNADETTE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-24",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "16-703",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "6602",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "TPSW1435",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904008281",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TRINA",
"last_name": "DAVIS-FORTUNE",
"middle_name": "B.",
"prefix": "MS.",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.