Renyale Treon Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8214 Issued in FL

Practice address

8400 N University Drive 219
Tamarac, FL 33321

Phone

(754) 238-6079

Fax

(000) 000-0000

NPI assigned

Dec 18, 2006

Last updated

Dec 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Renyale Treon Cotton Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• 2911 Therapy, LLC

  • Point of Service
  • Plantation, FL
  • NPI 1821746827
  NPD Authorized official
• Broward County

  dba Broward Addiction Recovery Division

  • Substance Abuse Rehabilitation Facility
  • Fort Lauderdale, FL
  • NPI 1326171034
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1376606921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 W OAKLAND PARK BLVD UNIT 190636",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333198725",
            "telephone_number": "754-238-6079",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 N UNIVERSITY DRIVE 219",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "33321",
            "telephone_number": "754-238-6079",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8400 N University Drive 219",
            "address_purpose": "LOCATION",
            "city": "Tamarac",
            "state": "FL",
            "postal_code": "33321",
            "country_code": "US",
            "telephone_number": "754-238-6079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RENYALE",
        "middle_name": "TREON",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-12-06",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767771500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "2911therapyllc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6240 W Oakland Park Blvd Unit 190636",
            "city": "Lauderhill",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333198725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RENYALE",
            "last_name": "COTTON",
            "middle_name": "TREON",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Swaraj Kumar Datta
• David S. Chen DPM PA
• David Seidner PT DC PA
• Eric W Davis
• Gabriella Damaris Davis, DPM
• Shamara Ariel Davis, PHARMD
• Robert Kenneth Dawes
• Leland S. Day, LCSW
• Saumya Dayal, ARNP
• DC Health Centers, PA

• Clinical Social Worker in Tamarac, FL
• Providers in Tamarac, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.