Renee Antoinette Davidson, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801089657 Issued in MI

Practice address

49455 Shelby Rd
Shelby Township, MI 48317-1559

Phone

(586) 255-9332

NPI assigned

Feb 8, 2007

Last updated

Aug 9, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

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.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596931200000",
    "number": "1568502201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49455 SHELBY RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171559",
            "telephone_number": "586-255-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49455 SHELBY RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171559",
            "telephone_number": "586-255-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RENEE",
        "middle_name": "ANTOINETTE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-09",
        "certification_date": "2020-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801089657",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samirkumar Dave, P.T.
• David J. Klida D.C., P.C.
• David W. Calton, M.D., P.C. (Washington Family Medicine)
• Brittany N David, PA
• Brandy Davidson, PHARMACY TECHNICIAN
• Alana Dawkins
• Amaan Dawood, MD
• Tyra Dean-Hassan, DONA
• Rachael Deblouw, RPH
• Bhumika Dedhia

• Social Worker in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.