Healthcare Provider Details

I. General information

NPI: 1821338120
Provider Name (Legal Business Name): CHELSEA DAVIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 VALLEY ROAD
LIBERTY CORNER NJ
07938-0132
US

IV. Provider business mailing address

PO BOX 132
LIBERTY CORNER NJ
07938-0132
US

V. Phone/Fax

Practice location:
  • Phone: 908-484-7354
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number445C05425400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: