MR. MARK HENDERSON DAVIS (NPI# 1457786998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457786998 |
| Entity Type | Individual |
| Full Name | MR. MARK HENDERSON DAVIS |
| Credential | LICSW |
| Practice Address |
5384 Street Ne Community Options Fridley Fridley MN 55421 |
| Practice Telephone | 7635720004 |
| Practice Fax Number | 7635721295 |
| Mailing Telephone | 7635720004 |
| Mailing Fax Number | 7635721295 |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2013-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
3796 | MN | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780225250 | Mark N Davis | Psychologist | 1479 Oak Ridge Dr, Chico, CA 95928-8856 | 2019-10-04 |
| 1841731924 | Mark Davis | Anesthesiology | 8237 Blackburn Ave Apt 103, Los Angeles, CA 90048-4277 | 2017-03-09 |
| 1336599588 | Mark Randall Davis | Specialist/Technologist | 1437 6th Street Cir Nw, Hickory, NC 28601-5255 | 2016-06-20 |
| 1891104865 | Mark Davis | Home Health Aide | 1916 Millgate Rd, Anderson, SC 29621-2936 | 2014-08-04 |
| 1699114082 | Mark David Davis | Behavioral Analyst | 12420 S Ridgeland Ave, Palos Heights, IL 60463-1858 | 2013-06-18 |
| 1376813808 | Mark Stephen Davis | Specialist | 4453 Mount Paran Pkwy Nw, Atlanta, GA 30327-3721 | 2011-12-30 |
| 1295053254 | Mark Davis | Pharmacist | 4185 Washington Rd, Mc Murray, PA 15317-2522 | 2010-05-13 |
| 1194968826 | Mark Anthony Davis | Driver | 448 E 272nd St, Euclid, OH 44132-1730 | 2009-04-10 |
| 1750542460 | Mark Alan Davis Sr. | Counselor | 147 Bryn Mawr Ave, Lansdowne, PA 19050-1806 | 2008-06-24 |
| 1598933806 | Mark William Davis | Emergency Medical Technician, Paramedic | Andrews Ave., Building 301, Fort Rucker, AL 36362 | 2008-02-20 |
| Street Address |
5384 STREET NE COMMUNITY OPTIONS FRIDLEY |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982241782 | Cc Group Home Care Inc | Non-emergency Medical Transport (VAN) | 524 Huset Pkwy Ne, Columbia Heights, MN 55421 | 2019-11-30 |
| 1710455324 | Victoria F Renner | Physical Therapist | 4512, 3700 Foss Rd, Minneapolis, MN 55421 | 2018-11-13 |
| 1245721976 | Complete Care Home Care LLC | Home Health | 4111 Central Ave Ne North Building, Suite 202, Columbia Heights, MN 55421 | 2018-05-29 |
| 1053816389 | Anoka Health Center LLC | Clinic/Center | 4111 Central Ave N.e, Suite 201 North Building, Columbia Heights, MN 55421 | 2018-03-28 |
| 1508381047 | Minnesota Home Health Care LLC | Home Health | 534 Huset Parkway, Columbia Heights, MN 55421 | 2017-08-05 |
| 1720520448 | Tesfa International School | Local Education Agency (LEA) | 1550 40th Avenue Northeast, Columbia Heights, MN 55421 | 2016-11-11 |
| 1487012548 | Icare Transportation | Non-emergency Medical Transport (VAN) | 2816 Silver Ln Ne #305, Saint Anthony, MN 55421 | 2016-02-04 |
| 1194183368 | Warsame Warsame | Non-emergency Medical Transport (VAN) | 1115 45th Ave Ne, Columbia Heights, MN 55421 | 2016-02-03 |
| 1083083398 | Epic Transportation LLC | Clinic/Center | 355 Orendorff Way Ne, Columbia Heights, MN 55421 | 2015-09-16 |
| 1508281023 | Alexandra Marie Hodson | Occupational Therapist | 5155 E. River Rd, Suite #403, Fridley, MN 55421 | 2014-02-20 |
| Find all providers in zip 55421 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932470127 | Catherine Rose Johanneck | Social Worker | 7362 University Ave Ne Ste 101, Fridley, MN 55432-3152 | 2012-01-19 |
| 1205099215 | Candice Kae Mohammad | Social Worker | 490 Fairmont St Ne, No Business, Fridley, MN 55432-1667 | 2008-07-09 |
| 1063528818 | Jodie Rae Holzman | Social Worker | 1026 64th Ave Ne, Fridley, MN 55432-5138 | 2006-08-22 |
| 1679516611 | Deanne Miller | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2006-06-14 |
| 1083226112 | Erin Kristine Church | Social Worker | 500 Osborne Rd Ne Ste 255, Fridley, MN 55432-2768 | 2020-08-19 |
| 1881237063 | Jennifer Lawrence | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-10-21 |
| 1568004323 | Moriah Mueller | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-10-14 |
| 1275194391 | Krysta Victoria Palmer | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-06-28 |
| 1154980068 | Autumn Michelle Phenow | Social Worker | 6341 University Ave Ne, Fridley, MN 55432-4946 | 2019-06-13 |
| 1548722200 | Krystal Vollmuth | Social Worker | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2019-04-02 |
| Find all providers in FRIDLEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.