Carolyn Davis, LCSW

Individual provider Active NPI Clinical Social Worker · Prospect, CT

NPI 1457688657 · NPPES record last updated Nov 9, 2009

Key facts

NPI
1457688657
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
003975 (CT)
Practice address
4 Summit Rd
C
Prospect, CT 06712-1485
Phone
(203) 758-0755
Fax
(203) 758-0754
NPI assigned
Nov 9, 2009
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

State licenses

LicenseStateTypeSpecialty
003975CTMDAdult Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 003975 CT Yes

Addresses

Primary practice location

4 Summit Rd
C
Prospect, CT 06712-1485

Mailing address

4 Summit Rd
C
Prospect, CT 06712-1485
Phone (203) 758-0755

Other providers in Prospect, CT

All providers in Prospect, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.