Randi Simone Davis, LICSW

Social Worker, Clinical in Boston, MA. Individual provider (NPI-1).

NPI number1366923633

StatusActive

Last updated in NPPESJan 4, 2021

Details

NPI: 1366923633
Entity type: Individual (NPI-1)
Name: Ms. Randi Simone Davis
Credential: LICSW
Sex: Female
Sole proprietor: No
Enumeration date: Aug 24, 2018
Certification date: Jan 4, 2021
Last updated: Jan 4, 2021

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
1041C0700X	Social Worker, Clinical	122616	MA	Yes
1041C0700X	Social Worker, Clinical	221957	MA

Practice location

75 Malcolm X Blvd
Boston, MA 02120-3106

Phone 617-635-8970

Mailing address

555 Page St Unit 204
Stoughton, MA 02072-6028

Phone 978-729-4437

Is something wrong?

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