Provider Demographics
NPI:1073805263
Name:DAVIS, SKYE (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:SKYE
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 E 26TH ST
Mailing Address - Street 2:STE 8
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1313
Mailing Address - Country:US
Mailing Address - Phone:763-560-9621
Mailing Address - Fax:763-560-9627
Practice Address - Street 1:5701 SHINGLE CREEK PKWY STE 550
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2475
Practice Address - Country:US
Practice Address - Phone:763-560-9621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN188491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical