Basic Information
| Provider Information | |||||||||
| NPI: | 1225484447 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAVIES | ||||||||
| FirstName: | PETER | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 53 KENDALL ST | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032351413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039343400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3008 BEVCHER DR | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122651918 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2016 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | NH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.