Individual provider Active NPI

Azizi Johari Daema Davis, LMSW,MS.ED

  • Clinical Social Worker
  • Valley Stream, NY
National Provider Identifier
1356650352
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
080988-1 Issued in NY
Practice address
96 Edgeworth St
Valley Stream, NY 11581-3236
Phone
(516) 872-1831
NPI assigned
Sep 25, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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 080988-1 NY Primary

Addresses

Primary practice location

96 Edgeworth St
Valley Stream, NY 11581-3236

Mailing address

96 Edgeworth St
Valley Stream, NY 11581-3236
Phone (516) 872-1831

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

LicenseStateTypeSpecialty
080988-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1285372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1356650352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 EDGEWORTH ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813236",
            "telephone_number": "516-872-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 EDGEWORTH ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813236",
            "telephone_number": "516-872-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AZIZI",
        "middle_name": "JOHARI DAEMA",
        "name_prefix": "Ms.",
        "credential": "LMSW,MS.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-25",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "080988-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.