Andrey Davydov, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17683 Issued in FL

Practice address

3800 N Hills Dr Apt 106
Hollywood, FL 33021-2541

Phone

(917) 463-6553

NPI assigned

Nov 4, 2020

Sex

Male

Sole proprietor

Yes

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

Enrolled in FL, NY2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

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.

• Life Is Good Therapy LLC

  • Clinical Social Worker
  • Hollywood, FL
  • NPI 1770174070
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1801497185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 N HILLS DR APT 106",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212541",
            "telephone_number": "917-463-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N HILLS DR APT 106",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212541",
            "telephone_number": "917-463-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVYDOV",
        "first_name": "ANDREY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karel J Davis
• Shaybre Raquel Davis
• Sheera Tzippora Davis
• Sydney Joyce Davis, PEER SPECIALIST, NOT
• T. Conswello Davis
• Casey Jennifer Dawson, PH.D.
• Natalie Dayan, M.S., CCC-SLP
• Dayclinic Inc.
• Karinna Vanessa Dazza
• DB Health Specialties Inc

• Clinical Social Worker in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.