MR. MARK HENDERSON DAVIS LICSW
NPI 1457786998
Social Worker - Clinical in Fridley, MN

Active since September 03, 2013
5384 STREET NE, COMMUNITY OPTIONS FRIDLEY, FRIDLEY, MN 55421(763) 572-0004(763) 572-1295 Get Directions Write a Review

NPPES record last updated: September 3, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Mark Henderson Davis Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARK HENDERSON DAVIS LICSW (NPI 1457786998) is an individual clinical provider in Fridley, Minnesota, licensed in Minnesota (3796) and active in the NPI registry since September 2013.

NPPES Registry Identity

NPI1457786998
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. MARK HENDERSON DAVISCredential: LICSW
Location Address5384 STREET NE, COMMUNITY OPTIONS FRIDLEYFridley, MN 55421
Mailing Address5384 Street Ne, Community Options FridleyFridley, MN 55421 · (763) 572-0004 · Fax (763) 572-1295
Fax(763) 572-1295
Sole ProprietorNo
Enumeration DateSeptember 3, 2013
NPI 1457786998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MN · 3796
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
5384 STREET NE, Fridley, MN 55421

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Davis's NPI number?

The NPI number for Mark Davis is 1457786998. It was assigned to this individual provider in the NPPES registry on September 3, 2013.

Where is Mark Davis located?

Mark Davis practices at 5384 Street NE Community Options Fridley, Fridley, MN 55421. The listed phone number is (763) 572-0004.

What is Mark Davis's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Mark Davis was last updated on September 3, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.