Provider Demographics
NPI:1508995549
Name:DAVIS, MARY FRAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY FRAN
Middle Name:
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 1:503 CLIFTON CT
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-7957
Mailing Address - Country:US
Mailing Address - Phone:270-885-4878
Mailing Address - Fax:270-885-6888
Practice Address - Street 1:1715 S VIRGINIA ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-3605
Practice Address - Country:US
Practice Address - Phone:270-885-4878
Practice Address - Fax:270-885-6888
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY13151041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical