Active NPI
Shanna Marie Davidson, LCSW
- Clinical Social Worker
- Louisville, KY
National Provider Identifier
1942514815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3845
- Practice address
- 3608 Stonyrun Dr
Louisville, KY 40220-5042 - Phone
- (502) 709-5567
- NPI assigned
- Aug 3, 2010
- Last updated
- Mar 31, 2017
- 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 | 3845 | KY | Primary |
Addresses
Primary practice location
3608 Stonyrun Dr
Louisville, KY 40220-5042
Mailing address
3608 Stonyrun Dr
Louisville, KY 40220-5042
Phone (502) 709-5567
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3845 | KY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Heart, Open Mind | Clinical | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Houston, TX
- NPI 1437815800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490918400000",
"number": "1942514815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3608 STONYRUN DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402205042",
"telephone_number": "502-709-5567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3608 STONYRUN DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402205042",
"telephone_number": "502-709-5567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "SHANNA",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-03",
"last_updated": "2017-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "3845",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.