Healthcare Provider Details

I. General information

NPI: 1730799487
Provider Name (Legal Business Name): CHRISTOPHER LUKE DAVIS LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

356 W 18TH ST
NEW YORK NY
10011-4401
US

IV. Provider business mailing address

356 W 18TH ST
NEW YORK NY
10011-4401
US

V. Phone/Fax

Practice location:
  • Phone: 212-271-7200
  • Fax:
Mailing address:
  • Phone: 212-271-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number100702
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: