Provider Demographics
NPI:1841388238
Name:DAVIS, NAOMI D (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:D
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 FRANKLIN ST
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-1502
Mailing Address - Country:US
Mailing Address - Phone:716-912-2661
Mailing Address - Fax:866-817-3362
Practice Address - Street 1:14 FRANKLIN ST
Practice Address - Street 2:SUITE 1003
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1502
Practice Address - Country:US
Practice Address - Phone:716-912-2661
Practice Address - Fax:866-817-3362
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0473701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical