Vincent M. Davis, SUDP, LICSWA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61417289 Issued in WA

Practice address

515 3Rd Ave
Seattle, WA 98104-2304

Phone

(206) 464-1570

NPI assigned

Oct 10, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Pioneer Human Services

  • Community/Behavioral Health Agency
  • Seattle, WA
  • NPI 1265554463
  NPD (past)

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1316412935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042304",
            "telephone_number": "206-464-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 3RD AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042304",
            "telephone_number": "206-464-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7440 W Marginal Way S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981084141",
            "country_code": "US",
            "telephone_number": "206-716-3613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981442839",
            "country_code": "US",
            "telephone_number": "206-470-3856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "VINCENT",
        "middle_name": "M.",
        "credential": "SUDP, LICSWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60844073",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP61367371",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61417289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas William Davis
• Tonja Lafaye Davis
• Trevor Davis, PSYD
• Trina Joy Davis, M.D.
• Vanessa Brooke Davis, DO
• Alana Davison, PSY.D.
• Elsy Davison
• James Davison Jr., PH.D.
• Jordan Davison
• Lela Davison

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.