JEREMY KEITH DAVIS LPCC LPC LADC SAC NPI 1518208206

NPI Information

NPI: 1518208206
Provider Name: JEREMY KEITH DAVIS, LPCC, LPC, LADC, SAC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

PECOS Registration: Yes

Address:
8200 HUMBOLDT AVE S STE 100
BLOOMINGTON, MN
ZIP 55431
Phone: (952) 454-0421
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Jeremy Keith Davis, LPCC, LPC, LADC, SAC is a mental health counselor in Bloomington, MN. Jeremy Keith Davis, LPCC, LPC, LADC, SAC NPI is 1518208206. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

8200 HUMBOLDT AVE S STE 100
BLOOMINGTON, MN
ZIP 55431-433
Phone: (952) 454-0421

The NPI 1518208206 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 3/6/2013 and was last updated on 11/5/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	5690-125	WISCONSIN	No
2	101YM0800X	Counselor	Mental Health	2076	MINNESOTA	Yes
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	15822-131	WISCONSIN	No
4	101YA0400X	Counselor	Addiction (Substance Use Disorder)	305108	MINNESOTA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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