Shawn Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8463 Issued in FL

Practice address

17633 Gunn Hwy #325
Odessa, FL 33556-1912

Phone

(813) 999-0955

Fax

(813) 607-6788

NPI assigned

Oct 2, 2007

Last updated

Apr 1, 2020By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Renew a Body Mind Strategy

  • Community/Behavioral Health Agency
  • Odessa, FL
  • NPI 1316103880
  Authorized official Same address or phone

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1922295146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17633 GUNN HWY #325",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335561912",
            "telephone_number": "813-999-0955",
            "fax_number": "813-607-6788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17633 GUNN HWY #325",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335561912",
            "telephone_number": "813-999-0955",
            "fax_number": "813-607-6788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHAWN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-02",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creative Growth Group Inc
• Crossroadz Coaching LLC
• Deborah D Abreu Regina Friedr
• Katherine Kay Daniels, M.S. CCC-SLP
• Berthy Dasque, R.N
• Monica A De la Llave
• Randall Charles Dean, RPT
• Sachi Del Marmol, FNP
• Yvonne Passavant Deming
• Dennis Linsey OD PA

• Clinical Social Worker in Odessa, FL
• Providers in Odessa, 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 Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.