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General NPI Number Information
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NPI Number | 1174261267
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Entity Type | Individual
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Provider Name | LAURA DAVIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 1613 BEAVER DAM RD STE 201
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City | POINT PLEASANT BORO
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State | NJ
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Zip | 08742-5171
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Country | US
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Telephone | 732-503-8627
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 226
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City | BEACHWOOD
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State | NJ
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Zip | 08722-0226
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Country | US
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Telephone | 732-691-1539
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Fax |
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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 | CW021205
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05791500
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License Number State | NJ
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