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NPI Code Detail

MEDICARE: MS. BRENDA DAVIDSON LISW, LICDC

MEDICARE: MS. BRENDA DAVIDSON LISW, LICDC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor882504OH
2104100000XSocial WorkerI-0000844OH

General Provider Information

NPI Number : 1942395561
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRENDA DAVIDSON LISW, LICDC
Provider Business Mailing Address
First Line : 2 EASTON OVAL
Second Line : STE 450
City : COLUMBUS
State : OH
Zip : 43219-6035
Country : US
Telephone Number : 614-475-9500
Fax Number :
Provider Business Practice Location Address
First Line : 2 EASTON OVAL
Second Line : STE 450
City : COLUMBUS
State : OH
Zip : 43219-6035
Country : US
Telephone Number : 614-475-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 09/11/2025

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