Brenda Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

063228 Issued in NY

Practice address

221 Palisade Avenue
Jersey City, NJ 07306

Phone

(201) 656-3116

Fax

(201) 656-9044

NPI assigned

May 16, 2007

Last updated

Aug 13, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Central Jersey Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1710199468
  NPD (past)
• NJ Behavioral Care Inc.

  • Psychiatry Physician
  • Jersey City, NJ
  • NPI 1770249385
  NPD (past)
• Palisade Behavioral Care, PA

  • Psychiatry Physician
  • West Orange, NJ
  • NPI 1235247248
  NPD (past)
• Shine Medical of Ca PC

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1942935473
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471046400000",
    "number": "1528275997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 BROADWAY",
            "address_2": "FL 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034709",
            "telephone_number": "201-656-3116",
            "fax_number": "201-656-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PALISADE AVENUE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07306",
            "telephone_number": "201-656-3116",
            "fax_number": "201-656-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRENDA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2016-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "063228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ENUMERATOR",
            "identifier": "1528275997",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Flores LLC
• Jenai Nicole David
• Eliana Brooke Davidoff
• Nancy E Davidson
• Cynthia Davies, LCAT, BC-DMT
• Dolores Elizabeth Davis, LPN
• Matthew B. Davis, M.D
• Marize Dawood
• Marie Day
• DB Dental Professional Corporation

• Clinical Social Worker in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.