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General NPI Number Information
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NPI Number | 1962383778
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Entity Type | Individual
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Provider Name | MARISA A DAVIDSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 65 FORDING PLACE RD
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City | LAKE KATRINE
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State | NY
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Zip | 12449-5221
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Country | US
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Telephone | 845-943-3650
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Fax |
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Provider Business Mailing Address
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Address Line | 7 HART DR
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City | POUGHKEEPSIE
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State | NY
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Zip | 12603-1147
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Country | US
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Telephone | 845-943-3650
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | 083272
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License Number State | NY
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