Active NPI
Tanika Davis, LSW
- Social Worker
- Philadelphia, PA
National Provider Identifier
1518289271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- SW122461
- Practice address
- 440 Glen Echo Rd
Philadelphia, PA 19119-2914 - Phone
- (267) 626-3091
- Fax
- (215) 242-9119
- NPI assigned
- Feb 23, 2010
- 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 | SW122461 | PA | Primary |
Addresses
Primary practice location
440 Glen Echo Rd
Philadelphia, PA 19119-2914
Mailing address
440 Glen Echo Rd
Philadelphia, PA 19119-2914
Phone (267) 626-3091
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1012180030 | Medicaid | PA |
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 |
|---|---|---|---|
| SW122461 | PA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266883200000",
"number": "1518289271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 GLEN ECHO RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191192914",
"telephone_number": "267-626-3091",
"fax_number": "215-242-9119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 GLEN ECHO RD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191192914",
"telephone_number": "267-626-3091",
"fax_number": "215-242-9119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TANIKA",
"name_prefix": "Miss",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-23",
"last_updated": "2010-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW122461",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1012180030",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.