Sherjuana Davis, PHD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW008505 Issued in GA

Practice address

1775 Parker Rd SE Ste 210
Conyers, GA 30094-6654

Phone

(678) 559-1943

NPI assigned

Jul 20, 2020

Sex

Female

Sole proprietor

No

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

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Georgia Mind Center LLC

  • Clinical Social Worker
  • Conyers, GA
  • NPI 1548950843
  NPD Authorized official

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1689282220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GORDON COMMERCIAL DR STE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302405754",
            "telephone_number": "706-845-4045",
            "fax_number": "706-845-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 PARKER RD SE STE 210",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946654",
            "telephone_number": "678-559-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHERJUANA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15937",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric D. Davis, M.D.
• Krystle Anne Davis
• Michelle Davis
• Niki Tanyell Davis
• Nona Camille Davis
• Martha Dawson
• Latisha Day
• Me'Ja R Day, M.D.
• Shaila Elyce Day, D.O.
• Nader A Dbouk, MD

• Clinical Social Worker in Conyers, GA
• Providers in Conyers, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; 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.