Provider Demographics
NPI:1386769750
Name:DAVISON, ANN L (LCSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:DAVISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:P
Other - Last Name:LUKACS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:170 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12443-5221
Mailing Address - Country:US
Mailing Address - Phone:512-785-3907
Mailing Address - Fax:
Practice Address - Street 1:170 HILLTOP DR
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:NY
Practice Address - Zip Code:12443-5221
Practice Address - Country:US
Practice Address - Phone:512-785-3907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX422671041C0700X
NYR0469121041C0700X
NCC0057801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical