Individual
MADISON DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
40 W CACHE VALLEY BLVD STE 7A, LOGAN, UT 84341-8475
(435) 538-2152
Mailing address
40 W CACHE VALLEY BLVD STE 7A, LOGAN, UT 84341-8475
(435) 538-2152
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11881326-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000055266
MEDICARE PIN
UT
01
—
260022408
RAILROAD
UT
05
—
8760003008007
—
UT
Enumeration date
07/13/2020
Last updated
02/24/2025
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