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NPI Code Detail

MEDICARE: ANDREW DAVIS MSW, LSW, CCHT

MEDICARE:   ANDREW  DAVIS  MSW, LSW, CCHT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
21041C0700XClinical Social WorkerS.2106429OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346759107
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DAVIS MSW, LSW, CCHT
Provider Business Mailing Address
First Line : 270 W LAKEVIEW AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43202-1047
Country : US
Telephone Number : 614-441-7333
Fax Number :
Provider Business Practice Location Address
First Line : 4236 E BROAD ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1279
Country : US
Telephone Number : 380-201-1315
Fax Number : 740-964-0030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2017
Last Update Date : 06/06/2023

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