MEDICARE: MR. MATTHEW HUNT DAVIS LMSW

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
1	1041C0700X	Clinical Social Worker	0738021	NY

General Provider Information

NPI Number	:	1609952712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MATTHEW HUNT DAVIS LMSW

Provider Business Mailing Address
First Line	:	315 ALBERTA DR STE 211
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1814
Country	:	US
Telephone Number	:	716-837-6705
Fax Number	:	716-837-6759

Provider Business Practice Location Address
First Line	:	315 ALBERTA DR STE 211
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1814
Country	:	US
Telephone Number	:	716-837-6705
Fax Number	:	716-837-6759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	01/22/2018

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