Individual ProviderAndrew M DavidsonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address1387 Lexington Rd Frnt House, Louisville, KY 40206-1926(502) 387-9074PECOS EnrollmentBased on the most recent information from CMS, provider Andrew M Davidson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1174645337Provider TypeIndividualFull NameDavidson, Andrew MTitleMr.CredentialLCSW,LCADCGenderMaleSole ProprietorNoEnumeration Date4/6/2007Last Updated3/8/2018Contact InformationPractice LocationPractice Address1387 Lexington Rd Frnt House, Louisville, KY 40206-1926Phone(502) 387-9074FaxUnlisted FaxMailing LocationMailing Address2021 Lakeside Dr, Louisville, KY 40205-2128Phone(502) 387-9074FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense3549KentuckyCode101YA0400XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseADCLAD00225188Kentucky