Edward Davidson, LICSW
Individual provider Active NPI Clinical Social Worker · Santa Fe, NM
NPI 1497271142 · NPPES record last updated Oct 6, 2025
Key facts
- NPI
- 1497271142
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C-12082 (NM)
- Practice address
- 3 Apache TRL
Santa Fe, NM 87505-1470 - Phone
- (505) 603-1103
- Fax
- (505) 438-6011
- NPI assigned
- Aug 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Santa Fe Mountain Center Inc
Practice addresses (Care Compare)
1524 B Bishops Lodge Rd
Santa Fe, NM 87506-0209
Phone (505) 983-6518
4001 Office Court Dr
Suite 906
Santa Fe, NM 87507-4929
Phone (505) 670-2861
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241122001377 | NM | Practitioner - Clinical Social Worker | 1153856406 | Reassigns benefits to 1 organization |
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.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M10037 | NM | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Santa Fe Mountain Center Inc | Current |
Accepting new patients |
Locations
4001 Office Court Dr
Ste 906
Santa Fe, NM 87507
Phone (505) 310-5654
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M10037 | NM | |
| Clinical Social Worker | 1041C0700X | C-12082 | NM | Yes |
Addresses
Primary practice location
3 Apache TRL
Santa Fe, NM 87505-1470
Mailing address
3 Apache TRL
Santa Fe, NM 87505-1470
Phone (505) 603-1103
Other providers in Santa Fe, NM
- David Vise OD, LLC
- Matthew David
- Jennifer Davidson Meadows
- Chantell Davidson, BMS
- Colleen Davidson
- Molly Davidson
- Joalie Emmanuelle Davie
- Ariel Loraine Davila
- Ava Davis
- Chad Joseph Davis
All providers in Santa Fe, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.