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General NPI Number Information
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NPI Number | 1114131125
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Entity Type | Individual
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Provider Name | VIVIAN ANN DAVIS MSW, LCSW CACII
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 10465 MELODY DR
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City | NORTHGLENN
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State | CO
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Zip | 80234-4119
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Country | US
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Telephone | 720-975-7371
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Fax | 720-362-5213
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Provider Business Mailing Address
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Address Line | 10465 MELODY DR
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City | NORTHGLENN
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State | CO
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Zip | 80234-4119
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Country | US
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Telephone | 720-975-7371
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Fax | 720-362-5213
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 939
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACB0006428
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License Number State | CO
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