Individual provider Active NPI

Yvonne Davis, LCSW

  • Clinical Social Worker
  • Atlanta, GA
National Provider Identifier
1366986143
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006973 Issued in GA
Practice address
1017 Fayetteville Rd SE
Suite B
Atlanta, GA 30316-2932
Phone
(404) 324-4190
NPI assigned
Dec 13, 2016
Last updated
Jan 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW007647 GA
Clinical Social Worker 1041C0700X CSW006973 GA Primary

Addresses

Primary practice location

1017 Fayetteville Rd SE
Suite B
Atlanta, GA 30316-2932

Mailing address

500 Northside Cir NW
Apt V2
Atlanta, GA 30309-2122

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
MSW007647GAMDSocial Worker
CSW006973GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1366986143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NORTHSIDE CIR NW",
            "address_2": "APT V2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 FAYETTEVILLE RD SE",
            "address_2": "SUITE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162932",
            "telephone_number": "404-324-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "YVONNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW007647",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.