Nathan Victor Davis, MSW, LSWAIC, SUDPT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW61022677 Issued in WA

Practice address

1608 Road 44
Pasco, WA 99301-2667

Phone

(509) 453-9820

Fax

(509) 545-6275

NPI assigned

Aug 17, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ndavis35792@yvfwc.direct-ci.com

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.

• Mindful Therapy Group PC

  dba Mindful Therapy Group

  • Clinical Social Worker
  • Mountlake Terrace, WA
  • NPI 1316238678

  Mental Health

  Medicare reassignment NPD
• Kadlec Regional Medical Center

  dba Kadlec Regional Medical Center - Express Care

  • Clinic/Center
  • Kennewick, WA
  • NPI 1063967933
  NPD
• Kadlec Regional Medical Center

  dba Kadlec Regional Medical Center - Rehab Unit

  • Rehabilitation Hospital Unit
  • Richland, WA
  • NPI 1790319580
  NPD
• Kadlec Regional Medical Center

  • General Acute Care Hospital
  • Richland, WA
  • NPI 1972507580

  Single Specialty

  NPD

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1922588094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 ROAD 44",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993012667",
            "telephone_number": "509-453-9820",
            "fax_number": "509-545-6275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "723 The Pkwy",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993524259",
            "country_code": "US",
            "telephone_number": "509-542-7878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 Gage Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993529531",
            "country_code": "US",
            "telephone_number": "509-942-3286",
            "fax_number": "509-628-1354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NATHAN",
        "middle_name": "VICTOR",
        "name_prefix": "Mr.",
        "credential": "MSW, LSWAIC, SUDPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-17",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO60889540",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC60633484",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61022677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndavis35792@yvfwc.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "YVFWC Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1608 Road 44",
            "city": "Pasco",
            "state": "WA",
            "country_code": "US",
            "postal_code": "993012667",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ruby Cruz
• Tonia Marie Damerow-Milton, LMP
• Alina Roxana Davidson, D.D.S.
• Bernedette Davis, MSW, LSWAIC
• Kacey Davis, LMP
• Ronald Eugene Davis, M.D.
• Scott O. Davis, MD
• Stefanie Marie Davis, R.D.
• Michelle Dawson, LMP
• Angela Lynn De la Rosa

• Clinical Social Worker in Pasco, WA
• Providers in Pasco, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.

Verify at the official NPI Registry.