Active NPI
Cynnamon Rae Davis, CSW
- Clinical Social Worker
- Salt Lake City, UT
National Provider Identifier
1851698187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6903653-3502
- Practice address
- 697 W 4170 S
Salt Lake City, UT 84123-1326 - Phone
- (801) 587-2460
- Fax
- (801) 281-5787
- NPI assigned
- Feb 23, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6903653-3502 | UT | Primary |
Addresses
Primary practice location
697 W 4170 S
Salt Lake City, UT 84123-1326
Mailing address
501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 587-2460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6903653-3502 | UT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1298419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433116800000",
"number": "1851698187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081222",
"telephone_number": "801-587-2460",
"fax_number": "801-281-5787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "697 W 4170 S",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841231326",
"telephone_number": "801-587-2460",
"fax_number": "801-281-5787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CYNNAMON",
"middle_name": "RAE",
"name_prefix": "Ms.",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-23",
"last_updated": "2015-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "6903653-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.