Lori Kay Davis, LICSW

Individual provider Active NPI Clinical Social Worker · Williston, VT

NPI 1891759775 · NPPES record last updated Jan 14, 2020

Key facts

NPI
1891759775
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
089-0000396 (VT)
Practice address
183 Talcott Rd Ste 206
Williston, VT 05495-2075
Phone
(802) 876-1100
Fax
(802) 876-1101
NPI assigned
Apr 17, 2006
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
089-0000396VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vermont Children'S Aid Society Clinical Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089-0000396 VT Yes

Addresses

Primary practice location

183 Talcott Rd Ste 206
Williston, VT 05495-2075

Mailing address

183 Talcott Rd Ste 206
Williston, VT 05495-2075
Phone (802) 876-1100

Other identifiers

IdentifierTypeStateIssuer
18984OtherVTBLUE CROSS BLUE SHIELD
03-0179601OtherVTCBA INSURANCE
383032OtherVTMVP HEALTH CARE
1007616MedicaidVT

Other providers in Williston, VT

All providers in Williston, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.