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General NPI Number Information
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NPI Number | 1619595477
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Entity Type | Individual
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Provider Name | MONEKKA NATAZIA DAVIS LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 6655 SANTA BARBARA RD
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City | ELKRIDGE
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State | MD
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Zip | 21075-7500
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Country | US
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Telephone | 866-968-6342
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Fax |
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Provider Business Mailing Address
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Address Line | 6655 SANTA BARBARA RD
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City | ELKRIDGE
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State | MD
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Zip | 21075-7500
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Country | US
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Telephone | 866-968-6342
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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 | 149.027790
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License Number State | IL
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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 | 0904017453
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 25997
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License Number State | MD
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