Provider Demographics
NPI:1831687003
Name:DAVIS, MADISON (LCSW)
Entity type:Individual
Prefix:
First Name:MADISON
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 1:4901 NOLENSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5411
Mailing Address - Country:US
Mailing Address - Phone:615-575-3783
Mailing Address - Fax:877-259-8932
Practice Address - Street 1:4901 NOLENSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5411
Practice Address - Country:US
Practice Address - Phone:615-575-3783
Practice Address - Fax:877-259-8932
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7530104100000X
IN34010519A1041C0700X
KY2532891041C0700X
TN70211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7021OtherSTATE LICENSE
KY7100576570Medicaid