Active NPI
Patricia A Davis, LCSW
- Social Worker
- Pine Bluff, AR
National Provider Identifier
1417247016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 064-C
- Practice address
- 6210 Dollarway Rd
Ste 4
Pine Bluff, AR 71602-3733 - Phone
- (870) 247-3588
- Fax
- (870) 247-2072
- NPI assigned
- Apr 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 064-C | AR | Primary |
Addresses
Primary practice location
6210 Dollarway Rd
Ste 4
Pine Bluff, AR 71602-3733
Mailing address
6210 Dollarway Rd
Ste 4
Pine Bluff, AR 71602-3733
Phone (870) 247-3588
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
| License | State | Type | Specialty |
|---|---|---|---|
| 064-C | AR | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BHC Pinnacle Pointe Hospital LLC | Past | Accepting new patients | |
| Uhs of Benton, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatric Hospital
- Little Rock, AR
- NPI 1912962341
-
- Adolescent and Children Mental Health Clinic/Center
- Pine Bluff, AR
- NPI 1699845818
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302825600000",
"number": "1417247016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6210 DOLLARWAY RD",
"address_2": "STE 4",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716023733",
"telephone_number": "870-247-3588",
"fax_number": "870-247-2072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6210 DOLLARWAY RD",
"address_2": "STE 4",
"city": "PINE BLUFF",
"state": "AR",
"postal_code": "716023733",
"telephone_number": "870-247-3588",
"fax_number": "870-247-2072"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "PATRICIA",
"middle_name": "A",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-15",
"last_updated": "2011-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "064-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine Bluff, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.