Carmen Miles Davis, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

14803 Issued in MD

Practice address

3355 Saint Johns LN
Ste F
Ellicott City, MD 21042-2600

Phone

(301) 503-5696

NPI assigned

Mar 18, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

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.

• Healing Sources LLC

  • Clinical Social Worker
  • Pikesville, MD
  • NPI 1528509270
  NPD (past) Authorized official

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

{
    "created_epoch": "1237334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479513600000",
    "number": "1801037015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 PLYMOUTH RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212086023",
            "telephone_number": "301-503-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 SAINT JOHNS LN",
            "address_2": "STE F",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422600",
            "telephone_number": "301-503-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CARMEN",
        "middle_name": "MILES",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-18",
        "last_updated": "2016-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "14803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021379900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitul N Dave, MD
• Rupal Dave, P.T.
• David D Lee DDS LLC
• Michelle David, PTA
• Risa Lynne Davis-Ganel, LCMFT
• Celia M. Davis
• Christina Dawn Davis, RMP
• Lisa Michelle Davis, PHD, PA-C
• Michelle Davis
• Patricia Shields Davis

• Clinical Social Worker in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2016; 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.