Provider Demographics
NPI:1114233178
Name:DAVIS, LAWANDA D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAWANDA
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4902
Mailing Address - Country:US
Mailing Address - Phone:305-321-3598
Mailing Address - Fax:
Practice Address - Street 1:7811 CORAL WAY STE 106
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6540
Practice Address - Country:US
Practice Address - Phone:305-412-0138
Practice Address - Fax:305-412-0138
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW16110101YM0800X, 1041C0700X
FL222Q00000X
FLISW344101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist