Provider Demographics
NPI:1104396225
Name:DAVIS, AMY (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:ZEILENGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3839 MERLE HAY RD STE 227
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1312
Mailing Address - Country:US
Mailing Address - Phone:515-669-8111
Mailing Address - Fax:515-462-0633
Practice Address - Street 1:3839 MERLE HAY RD STE 227
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1312
Practice Address - Country:US
Practice Address - Phone:515-669-8111
Practice Address - Fax:515-462-0633
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-01
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0910421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical