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

Ethan Davis, LCSW

Individual provider Clinical Social Worker · NPI 1023462728

Ethan Davis, LCSW is a Clinical Social Worker in Roseville, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2016
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

300 Harding Blvd Ste 108
Roseville, CA 95678-2471
Phone: (916) 741-0884
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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 102727 (CA)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1023462728
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedApril 19, 2016
Last updated in NPPESNovember 23, 2021
Certification dateNovember 23, 2021

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