Renee Lee Davidson, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149016263 Issued in IL

Practice address

396 Barkwood LN
Glen Carbon, IL 62034-1528

Phone

(314) 660-5138

NPI assigned

May 29, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1609077502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 BARKWOOD LN",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341528",
            "telephone_number": "314-660-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 BARKWOOD LN",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341528",
            "telephone_number": "314-660-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RENEE",
        "middle_name": "LEE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2007011917",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Cruz, MD
• Brianna Elizabeth Cullen
• Rachel Lynn Daly, LCSW
• Addison Leigh Daniels
• Eva Madelyn Danley
• Anna Mae Dellamano
• Virginia Lee Dellamano, LCPC CSADC
• Dental Professionals of Illinois, P.C. (Sunset Hills Family Dental)
• Dental Professionals of Illinois, P.C. (Glen Carbon Family Dentistry)
• Brittany Denton

• Clinical Social Worker in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; 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.