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NPI Code Detail

MEDICARE: JENNIFER R. DAVIS MSW, LISW

MEDICARE: JENNIFER R. DAVIS MSW, LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI.1201479OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093020067
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER R. DAVIS MSW, LISW
Provider Business Mailing Address
First Line : 737 E HUDSON ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1034
Country : US
Telephone Number : 614-365-8311
Fax Number : 614-365-8615
Provider Business Practice Location Address
First Line : 737 E HUDSON ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1034
Country : US
Telephone Number : 614-365-8311
Fax Number : 614-365-8615
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2010
Last Update Date : 02/04/2016

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