Individual provider Active NPI

Taylor Davis, LMSW

  • Clinical Social Worker
  • Hartford, MI
National Provider Identifier
1376058792
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114897 Issued in MI
Practice address
57418 County Road 681 Ste C
Hartford, MI 49057-9422
Phone
(269) 427-5671
NPI assigned
Dec 7, 2017
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801099625 MI
Clinical Social Worker 1041C0700X 6801114897 MI Primary

Addresses

Primary practice location

57418 County Road 681 Ste C
Hartford, MI 49057-9422

Mailing address

801 Hazen St Ste C
Paw Paw, MI 49079-2008

Other names 1

  • Taylor Foco Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722002026 MI Practitioner - Clinical Social Worker 4587045414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Van Buren Community Mental Health AuthorityGroup PAC ID 6800863788, 22 clinicians

Practice addresses (Care Compare)

801 Hazen St
Suite C
Paw Paw, MI 49079-2008
Phone (269) 657-5574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801099625MIMDClinical Social Worker
6801114897MIMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1512604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1376058792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 HAZEN ST STE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490792008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57418 COUNTY ROAD 681 STE C",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490579422",
            "telephone_number": "269-427-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TAYLOR",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-07",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801099625",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "FOCO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, MI

Sources for this page

Verify at the official NPI Registry.