Provider Demographics
NPI:1164436762
Name:DAVIDSON, STEVEN THOMAS (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:THOMAS
Last Name:DAVIDSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 MOSS ROSE DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37216-2930
Mailing Address - Country:US
Mailing Address - Phone:615-516-9806
Mailing Address - Fax:615-227-3152
Practice Address - Street 1:333 GALLATIN PIKE S
Practice Address - Street 2:SUITE 13
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-4001
Practice Address - Country:US
Practice Address - Phone:615-516-9806
Practice Address - Fax:615-227-3152
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4117921OtherBLUE CROSS BLUE SHIELD
TN3691840Medicare ID - Type Unspecified