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Theresa Davis, LBSW

Social Worker in Detroit, MI. Individual provider (NPI-1).

NPI number1750604393
StatusActive
Last updated in NPPESSep 1, 2023

Details

NPI
1750604393
Entity type
Individual (NPI-1)
Name
Mrs. Theresa Davis
Credential
LBSW
Sex
Female
Sole proprietor
No
Enumeration date
Mar 10, 2010
Certification date
Sep 1, 2023
Last updated
Sep 1, 2023

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 codeDescriptionLicenseStatePrimary
104100000X Social Worker6802075385MIYes

Practice location

8600 Woodward Ave
Detroit, MI 48202-2142

Phone 313-875-7601

Mailing address

8600 Woodward Ave
Detroit, MI 48202-2142

Phone 313-875-7601

Other practice locations

16200 E 19 Mile Rd
Clinton Twp, MI 48038-3543

Phone 586-263-8782

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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