Active NPI
Jennifer Marie Davis, LMSW
- Social Worker
- Deer Park, NY
National Provider Identifier
1962045369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 098380
- Practice address
- 770 Grand Blvd
Deer Park, NY 11729-5750 - Phone
- (631) 392-4357
- NPI assigned
- Oct 18, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 098380 | NY | Primary |
Addresses
Primary practice location
770 Grand Blvd
Deer Park, NY 11729-5750
Mailing address
5 Pearl CT
West Islip, NY 11795-2222
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 |
|---|---|---|---|
| 098380 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571356800000",
"number": "1962045369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 PEARL CT",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117952222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "770 GRAND BLVD",
"city": "DEER PARK",
"state": "NY",
"postal_code": "117295750",
"telephone_number": "631-392-4357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JENNIFER",
"middle_name": "MARIE",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-18",
"last_updated": "2019-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "098380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deer Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.