Active NPI
Carol N Davis, LCSW
- Clinical Social Worker
- Staten Island, NY
National Provider Identifier
1871567453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SC10170
- Practice address
- 450 Seaview Ave
Staten Island, NY 10305-3401 - Phone
- (718) 226-8912
- NPI assigned
- Feb 13, 2006
- 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 | SC10170 | NJ | Primary |
Addresses
Primary practice location
450 Seaview Ave
Staten Island, NY 10305-3401
Mailing address
1 Edgewater St
6TH Floor
Staten Island, NY 10305-4900
Phone (718) 226-1008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00832900 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050415000097 | NJ | Practitioner - Clinical Social Worker | 9234176769 | Practice locations: Eatontown, NJ |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
615 Hope Rd
Suite 5B
Eatontown, NJ 07724-1273
Phone (917) 972-7372
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC10170 | NJ | MD | Clinical Social Worker |
| 029417 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faith and Hope Psychotherapy, LCSW, PLLC | Clinical | 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.
-
- Clinical Social Worker
- Staten Island, NY
- NPI 1073985214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871567453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EDGEWATER ST",
"address_2": "6TH FLOOR",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103054900",
"telephone_number": "718-226-1008",
"fax_number": "718-226-1039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053401",
"telephone_number": "718-226-8912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CAROL",
"middle_name": "N",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "SC10170",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00832900",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.