Brooke Lauren Davidson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW020264 Issued in PA

Practice address

1912 South St Apt C
Philadelphia, PA 19146-1478

Phone

(914) 261-4122

NPI assigned

Jan 6, 2016

Last updated

Jun 16, 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

Electronic endpoints 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.

• Special People in Northeast, Inc.

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1013044304
  NPD (past)

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1619333655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 SOUTH ST APT C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461478",
            "telephone_number": "914-261-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 SOUTH ST APT C",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461478",
            "telephone_number": "914-261-4122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10541 Drummond Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191543807",
            "country_code": "US",
            "telephone_number": "215-613-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "BROOKE",
        "middle_name": "LAUREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020264",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "SW133070",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Philadelphia",
            "affiliation": "N",
            "address_1": "1912 South St Apt C",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191461478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Virginia Davidov, LCSW
• Shannon Aileen Davids, M.D.
• Alexander Davidson, MD
• Alexandra Rose Davidson
• Alphonzo Lowell Davidson III, DDS
• Brooke M Davidson, LCSW
• Carol Ann Davidson
• Dalton Patrick Davidson, DO
• Elizabeth Suzanne Davidson, MD
• Jessica M. Davidson, M.D.

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.