Edward Davidson, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-12082 Issued in NM

Practice address

3 Apache TRL
Santa Fe, NM 87505-1470

Phone

(505) 603-1103

Fax

(505) 438-6011

NPI assigned

Aug 15, 2017

Last updated

Oct 6, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Santa Fe Mountain Center IncGroup PAC ID 6406272608, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Santa Fe Mountain Center Inc

  dba The Mountain Center

  • Community/Behavioral Health Agency
  • Tesuque, NM
  • NPI 1861695769
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1497271142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 APACHE TRL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051470",
            "telephone_number": "505-603-1103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 APACHE TRL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051470",
            "telephone_number": "505-603-1103",
            "fax_number": "505-438-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "EDWARD",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "M10037",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-12082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Vise OD, LLC
• Matthew David, LPCC
• Jennifer Davidson Meadows, RWP
• Chantell Davidson, BMS
• Colleen Davidson
• Molly Davidson
• Joalie Emmanuelle Davie, M.D.
• Ariel Loraine Davila, PT, DPT
• Ava Davis
• Chad Joseph Davis, DDS

• Clinical Social Worker in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.