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

Mr. Mark Henderson Davis, LICSW

Individual provider Clinical Social Worker · NPI 1457786998

Mr. Mark Henderson Davis, LICSW is a Clinical Social Worker in Fridley, Minnesota. Licensed in Minnesota. Registered with an NPI since 2013.

Licensed in
MN
In the registry since
2013
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

5384 Street NE Community Options Fridley
Fridley, MN 55421
Phone: (763) 572-0004
Fax: (763) 572-1295
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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 3796 (MN)

Record details

NPI number1457786998
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedSeptember 3, 2013
Last updated in NPPESSeptember 3, 2013

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