Active NPI
Mary Harrison Davis, LCSWC
- Clinical Social Worker
- Easton, MD
National Provider Identifier
1992883391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 04589
- Practice address
- 29520 Canvasback Dr
Easton, MD 21601-7124 - Phone
- (410) 822-5007
- Fax
- (410) 822-5569
- NPI assigned
- Nov 2, 2006
- 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 | 04589 | MD | Primary |
Addresses
Primary practice location
29520 Canvasback Dr
Easton, MD 21601-7124
Mailing address
2336 Goddard Parkway
Salisbury, MD 21801
Phone (410) 334-6961
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 259147000 | Other | MD | MAGELLAN GROUP |
| 522156095 | Other | MD | AMERICAN PSYCH SYSTEM |
| 609550002 | Medicaid | MD | |
| LM49EA | Other | MD | CAREFIRST BCBS GROUP |
| 0031 | Other | MD | CAREFIRST BCBS FEDERAL |
| 517251 | Other | UHC MAMSI GROUP | |
| 522156095 | Other | MD | UNITED BEHAVIORAL HEALTH |
| R968 | Other | DC | CAREFIRST FEDERAL GROUP |
| 761936 | Other | MD | NCPPO |
| 892138-01 | Other | MD | CAREFIRST BCBS |
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Shore Psychological Service | Past | Accepting new patients | |
| Gulf Coast Counseling, Inc | Clinical | Past | Accepting new patients |
| Eastern Shore Psychological Service, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Salisbury, MD
- NPI 1548348402
-
- Community/Behavioral Health Agency
- Princess Anne, MD
- NPI 1730252537
-
- Clinical Social Worker
- Englewood, FL
- NPI 1861602005
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315440000000",
"number": "1992883391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2336 GODDARD PARKWAY",
"city": "SALISBURY",
"state": "MD",
"postal_code": "21801",
"telephone_number": "410-334-6961",
"fax_number": "410-334-6362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29520 CANVASBACK DR",
"city": "EASTON",
"state": "MD",
"postal_code": "216017124",
"telephone_number": "410-822-5007",
"fax_number": "410-822-5569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MARY",
"middle_name": "HARRISON",
"name_prefix": "Mrs.",
"credential": "LCSWC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2011-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "04589",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN GROUP",
"identifier": "259147000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN PSYCH SYSTEM",
"identifier": "522156095",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "609550002",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS GROUP",
"identifier": "LM49EA",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS FEDERAL",
"identifier": "0031",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC MAMSI GROUP",
"identifier": "517251",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEHAVIORAL HEALTH",
"identifier": "522156095",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST FEDERAL GROUP",
"identifier": "R968",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO",
"identifier": "761936",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "892138-01",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Easton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.