Healthcare Provider Details

I. General information

NPI: 1831525955
Provider Name (Legal Business Name): AMY DANIELLE DAVIDSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 N CENTRAL AVE STE 1170
PHOENIX AZ
85012-2694
US

IV. Provider business mailing address

3101 N CENTRAL AVE STE 1170
PHOENIX AZ
85012-2694
US

V. Phone/Fax

Practice location:
  • Phone: 602-558-1727
  • Fax:
Mailing address:
  • Phone: 602-558-1727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-21942
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLISW-I2507477
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: