Healthcare Provider Details

I. General information

NPI: 1851402416
Provider Name (Legal Business Name): CYNTHIA J DAVIS MSW, LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 PERRY HILL RD
MONTGOMERY AL
36109-3725
US

IV. Provider business mailing address

420 E SARNIA ST STE 2100
WINONA MN
55987-6414
US

V. Phone/Fax

Practice location:
  • Phone: 334-272-4670
  • Fax: 334-725-2986
Mailing address:
  • Phone: 507-454-4341
  • Fax: 507-453-6267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number31627
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1090G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: