Oliver James Davis Jr., MSW, LCSW, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003612A Issued in IN

Practice address

6910 N Main St Unit 4
Granger, IN 46530

Phone

(574) 876-6938

Fax

(574) 931-2679

NPI assigned

Mar 29, 2010

Last updated

Nov 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mitchell R Goldstein, MD

  • Professional Counselor
  • South Bend, IN
  • NPI 1700196698
  NPD (past)

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

{
    "created_epoch": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1962727305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 N MAIN ST UNIT 4",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309681",
            "telephone_number": "574-876-6938",
            "fax_number": "574-931-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 N MAIN ST UNIT 4",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "46530",
            "telephone_number": "574-876-6938",
            "fax_number": "574-931-2679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6910 N Main St Unit 4",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "46530",
            "country_code": "US",
            "telephone_number": "574-876-6938",
            "fax_number": "574-931-2679",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "OLIVER",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW, LCSW, LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801066829",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003612A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Cunningham, PT, DPT
• Tess Lacie Curnyn, DO
• Cynthia Shepherd, LCSW, LLC
• Stacey Ann Dalby, OTR/L
• Karen D. Davis, M.D.
• Travis Van Deaton
• Anna K Detlefsen, LCSW
• Gabriel Detweiler
• Sharon E Devinney, PH.D., HSPP
• Michael Dewit, OD

• Clinical Social Worker in Granger, IN
• Providers in Granger, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.