MR. ERIC SAMUEL DAVIS (LCSW) – Addiction (Substance Use Disorder) Counselor, NPI 1790990224

MR. ERIC SAMUEL DAVIS (LCSW) is a healthcare provider. based in Salem, Oregon. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 7843 (OR). The NPI Number for MR. ERIC SAMUEL DAVIS (LCSW) is 1790990224

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
MR. ERIC SAMUEL DAVIS (LCSW)
NPI
1790990224
Phone
(503) 877-1995
Address
608 LANCASTER DR SE
Enumeration Date
10 May 2007
Last Update Date
9 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2005 (21 years ago)
PAC ID
0547503609
Group Practice PAC ID
6204729288
Professional Enrollment ID
I20190514000976
Address ID
OR973802036SI200XXRDXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness75
Years active:19State licenses:3Digital endpointsOther names

1,405 CLINICAL SOCIAL WORKER in OR

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Provider Addresses for MR. ERIC SAMUEL DAVIS (LCSW)

  • 608, Lancaster Drive Southeast, Salem, Marion County, Oregon, 97317, United States

    SALEM, OR 973175643

    Phone: (503) 877-1995

    Fax: (503) 877-1995

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-05-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190514000976IClinical Social WorkerORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97317)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204729288View full group profile
NameSpecialtyState
Internal MedicineOR
Nurse PractitionerOR
Nurse PractitionerOR
Internal MedicineCA
O P T O M E T R YCA
Nurse PractitionerOR
Nurse PractitionerOR

Reviews

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Frequently asked questions

What is MR. ERIC SAMUEL DAVIS (LCSW)'s NPI number?
MR. ERIC SAMUEL DAVIS (LCSW)'s NPI is 1790990224 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to MR. ERIC SAMUEL DAVIS (LCSW)?
You should see MR. ERIC SAMUEL DAVIS (LCSW) as active in CMS-hosted NPPES data.
What expertise is attributed to MR. ERIC SAMUEL DAVIS (LCSW)?
MR. ERIC SAMUEL DAVIS (LCSW)'s specialty line reads Addiction (Substance Use Disorder) Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MR. ERIC SAMUEL DAVIS (LCSW)?
Travel planning: use Salem, Oregon as the reference point for MR. ERIC SAMUEL DAVIS (LCSW), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.