MEDICARE: AMY S DAVIS LCSW

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
1	251S00000X	Community/Behavioral Health Agency	LC21612	ME
2	1041C0700X	Clinical Social Worker	LC21612	ME

General Provider Information

NPI Number	:	1346884681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY S DAVIS LCSW

Provider Business Mailing Address
First Line	:	181 FRANKLIN HEALTH CMNS
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6144
Country	:	US
Telephone Number	:	207-778-0482
Fax Number	:	207-778-0133

Provider Business Practice Location Address
First Line	:	181 FRANKLIN HEALTH CMNS
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6144
Country	:	US
Telephone Number	:	207-778-0482
Fax Number	:	207-778-0133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2019
Last Update Date	:	03/16/2026

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