Individual provider Active NPI

Donna Davey, LICSW

  • Clinical Social Worker
  • Vineyard Haven, MA
National Provider Identifier
1992853998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112151 Issued in MA
Practice address
15 Church Street
Vineyard Haven, MA 02568
Phone
(508) 693-5523
Fax
(508) 693-8619
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 112151 MA Primary

Addresses

Primary practice location

15 Church Street
Vineyard Haven, MA 02568

Mailing address

38 Puritan Drive
Edgartown, MA 02539
Phone (508) 693-5523

Other identifiers 2

IdentifierTypeStateIssuer
773990000OtherMAMAGELLAN
P08420OtherMABLUE CROSS BLUE SHIELD

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

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992853998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 PURITAN DRIVE",
            "city": "EDGARTOWN",
            "state": "MA",
            "postal_code": "02539",
            "telephone_number": "508-693-5523",
            "fax_number": "508-693-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CHURCH STREET",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "02568",
            "telephone_number": "508-693-5523",
            "fax_number": "508-693-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVEY",
        "first_name": "DONNA",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "112151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "773990000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "P08420",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineyard Haven, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.