Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Desiree Davis

Individual provider Clinical Social Worker · NPI 1164240172

Desiree Davis is a Clinical Social Worker in South Bend, Indiana. Qualified in 2017, 9 years ago. Practices with The South Bend Clinic LLC, a 170-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
9
Licensed in
IN
In the registry since
2024
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Practice location Address checks out

211 N Eddy St
South Bend, IN 46617-2808
Phone: (574) 234-8161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 34002322A (IN)

Record details

NPI number1164240172
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 30, 2024
Last updated in NPPESSeptember 30, 2024
Certification dateSeptember 29, 2024
Mailing address430 Kosciuszko St, South Bend, IN 46619-3508

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice The South Bend Clinic Llc — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in South Bend