Provider Demographics
NPI:1528183886
Name:DAVIS, JUDITH P (MSW, LICSW, DCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:P
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW, LICSW, DCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7912 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3829
Mailing Address - Country:US
Mailing Address - Phone:301-299-6137
Mailing Address - Fax:202-775-1185
Practice Address - Street 1:7912 HORSESHOE LN
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3829
Practice Address - Country:US
Practice Address - Phone:301-299-6137
Practice Address - Fax:202-775-1185
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD065511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical