Individual provider Active NPI

Sanetria Davis

  • Clinical Social Worker
  • Desoto, TX
National Provider Identifier
1942962717
Registry record updated Oct 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
66355 Issued in TX
Practice address
1221 Bluebonnet Dr
Desoto, TX 75115-6682
Phone
(214) 206-7779
NPI assigned
Oct 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2021

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 66355 TX
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 66355 TX
Adolescent and Children Mental Health Clinic/Center 261QM0855X 66355 TX
Assisted Living Facility (Mental Illness) 3104A0625X
Mental Health Counselor 101YM0800X 66355 TX
Case Manager/Care Coordinator 171M00000X 66355 TX
Case Management Agency 251B00000X 66355 TX
Community/Behavioral Health Agency 251S00000X 66355 TX
Assisted Living Facility (Mental Illness) 3104A0625X 66355 TX
Mental Illness Intermediate Care Facility 310500000X 66355 TX
Mental Illness Community Based Residential Treatment Facility 320800000X 66355 TX
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 66355 TX
Psychiatric Residential Treatment Facility 323P00000X 66355 TX
Substance Abuse Rehabilitation Facility 324500000X 66355 TX
Clinical Social Worker 1041C0700X 66355 TX Primary

Addresses

Primary practice location

1221 Bluebonnet Dr
Desoto, TX 75115-6682

Mailing address

1221 Bluebonnet Dr
Desoto, TX 75115-6682
Phone (214) 206-7779

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sanetria Davis, LCSW Mental Health CurrentSince Jul 17, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633737600000",
    "number": "1942962717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 BLUEBONNET DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751156682",
            "telephone_number": "214-206-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 BLUEBONNET DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751156682",
            "telephone_number": "214-206-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SANETRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-09",
        "last_updated": "2021-10-09",
        "certification_date": "2021-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TX",
            "license": "66355",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2021; 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.