Theresa Davis, LBSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802075385 Issued in MI

Practice address

8600 Woodward Ave
Detroit, MI 48202-2142

Phone

(313) 875-7601

NPI assigned

Mar 10, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

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": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1750604393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022142",
            "telephone_number": "313-875-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8600 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022142",
            "telephone_number": "313-875-7601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16200 E 19 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Clinton Twp",
            "state": "MI",
            "postal_code": "480383543",
            "country_code": "US",
            "telephone_number": "586-263-8782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "THERESA",
        "name_prefix": "Mrs.",
        "credential": "LBSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-10",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802075385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shatara Vivian Davis
• Shenicak Kujuana Davis
• Stacy Davis, IBCLC
• Tamara Davis
• Tasha Davis, LLMSW
• Tiffany Davis
• Tonja Davis, LPN
• Tracy Ann Davis
• Weston Alexander Davis
• William Davis, DO

• Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.