Provider Demographics
NPI:1144475021
Name:DAVIS, DOROTHY ALICE (SOCIAL WORKER)
Entity type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:ALICE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:ALICE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSWR
Mailing Address - Street 1:83 HALLS CORNERS RD
Mailing Address - Street 2:
Mailing Address - City:DOVER PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12522-5200
Mailing Address - Country:US
Mailing Address - Phone:845-877-0103
Mailing Address - Fax:845-877-0103
Practice Address - Street 1:83 HALLS CORNERS RD
Practice Address - Street 2:
Practice Address - City:DOVER PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12522-5200
Practice Address - Country:US
Practice Address - Phone:845-877-0103
Practice Address - Fax:845-877-0103
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR034049-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical