Peggy Davenport, LISW

Individual provider Active NPI Clinical Social Worker · Madison, OH

NPI 1386844488 · NPPES record last updated Nov 11, 2008

Key facts

NPI
1386844488
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
I0700253 (OH)
Practice address
15 W Main St
Madison, OH 44057-3125
Phone
(440) 227-9999
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
I0700253OHMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0700253 OH Yes

Addresses

Primary practice location

15 W Main St
Madison, OH 44057-3125

Mailing address

15 W Main St
Madison, OH 44057-3125
Phone (440) 227-9999

Other providers in Madison, OH

All providers in Madison, OH · Clinical Social Worker in Ohio

Sources for this page

Verify at the official NPI Registry.