Joan W Davis, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

59761 Issued in TX

Practice address

804 Waterloo Lake Dr
Denison, TX 75020-5437

Phone

(903) 327-3643

Fax

(580) 745-9891

NPI assigned

Oct 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Locations

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.

• Supportive Care LLC

  • Clinical Psychologist
  • Garland, TX
  • NPI 1477895043
  Medicare reassignment NPD

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1871997999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 WATERLOO LAKE DR",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750205437",
            "telephone_number": "903-327-3643",
            "fax_number": "580-745-9891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 WATERLOO LAKE DR",
            "city": "DENISON",
            "state": "TX",
            "postal_code": "750205437",
            "telephone_number": "903-327-3643",
            "fax_number": "580-745-9891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOAN",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "59761",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cura Residential Living Inc.
• CVS Pharmacy Inc
• Dallas County Hospital District
• Clarence Daughrity
• Alvin V Davis III, MD
• Joshua James Davis, D.C.
• Dianna L Dean, LPC
• Deanna M Jones
• Vanessa Deering
• Denison Chiropractic, Inc

• Clinical Social Worker in Denison, TX
• Providers in Denison, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.