Lucca Davis

Key facts

NPI

1548075971

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

096067 (NY)

Practice address

138 Brush Hollow Cres
Rye Brook, NY 10573-1628

Phone

(917) 843-0633

NPI assigned

Feb 12, 2025

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

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 12, 2025.

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1548075971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 BRUSH HOLLOW CRES",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731628",
            "telephone_number": "917-843-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 BRUSH HOLLOW CRES",
            "city": "RYE BROOK",
            "state": "NY",
            "postal_code": "105731628",
            "telephone_number": "917-843-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LUCCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rye Brook, NY

• CVS Albany LLC
• Cynthia Dunn LCSW, PLLC
• Joan A Davan, PT
• David P. Rosenzweig, DPM, PC
• Gerald Fredric Davis, M.D.
• Mellisa Deandrade
• Michelle Delaurentiis
• Olivia Delaurentiis
• David A. Della Rocca, MD
• Michael Neal Demaio, RPH

All providers in Rye Brook, NY · Clinical Social Worker in New York