Active NPI
Rayven Brayonna Davis, LLMSW
- Social Worker
- Southfield, MI
National Provider Identifier
1295304459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 21700 Northwestern Hwy
Southfield, MI 48075-4906 - Phone
- (855) 445-4554
- NPI assigned
- Jun 22, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
21700 Northwestern Hwy
Southfield, MI 48075-4906
Mailing address
14095 Shadywood Dr Apt 157
Plymouth, MI 48170-3161
Phone (313) 330-7085
Other names 1
- Rayven Brayonna Fuller
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rayven.davis@pacesemi.org | ||
| Direct Messaging Address | rayven.davis@pacesemi.org | Pace of Southeast Michigan, Inc. |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1295304459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14095 SHADYWOOD DR APT 157",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481703161",
"telephone_number": "313-330-7085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21700 NORTHWESTERN HWY",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754906",
"telephone_number": "855-445-4554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RAYVEN",
"middle_name": "BRAYONNA",
"credential": "LLMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rayven.davis@pacesemi.org",
"affiliation": "N",
"address_1": "21700 Northwestern Hwy",
"city": "Southfield",
"state": "MI",
"country_code": "US",
"postal_code": "480754906",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rayven.davis@pacesemi.org",
"affiliation": "Y",
"affiliationName": "Pace of Southeast Michigan, Inc.",
"address_1": "21700 Northwestern Hwy",
"city": "Southfield",
"state": "MI",
"country_code": "US",
"postal_code": "480754906",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "RAYVEN",
"last_name": "FULLER",
"middle_name": "BRAYONNA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.