| Craig A Davis Lcsw Pllc | |
|
2150 N Rio De Flag Dr Flagstaff AZ 86004-7503 | |
| (382) 699-3571 | |
| Not Available |
| Full Name | Craig A Davis Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2150 N Rio De Flag Dr, Flagstaff, Arizona |
| Authorized Official Name and Position | Craig Davis (OWNER) |
| Authorized Official Contact | 9286993571 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig A Davis Lcsw Pllc 2150 N Rio De Flag Dr Flagstaff AZ 86004-7503 Ph: (382) 699-3571 | Craig A Davis Lcsw Pllc 2150 N Rio De Flag Dr Flagstaff AZ 86004-7503 Ph: (382) 699-3571 |
| NPI Number | 1437640638 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 05/23/2018 |
| Medicare PECOS PAC ID | 0042558264 |
|---|---|
| Medicare Enrollment ID | O20190214000240 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437640638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-14134 (Arizona) | Primary |
| Provider Name | Craig A Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225278930 PECOS PAC ID: 8325351216 Enrollment ID: I20150721002783 |
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