Provider Demographics
NPI:1932836145
Name:DAVIS, CAROLYN J (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:J
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 1:201 RODMAN AVE
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2012
Mailing Address - Country:US
Mailing Address - Phone:267-278-0217
Mailing Address - Fax:
Practice Address - Street 1:201 RODMAN AVE
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2012
Practice Address - Country:US
Practice Address - Phone:267-278-0217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical