Provider Demographics
NPI:1528269453
Name:DAVIS, JAMISON EMILE (MAPC, LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:JAMISON
Middle Name:EMILE
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MAPC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 SAX LEIGH DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75241-6913
Mailing Address - Country:US
Mailing Address - Phone:214-375-0837
Mailing Address - Fax:
Practice Address - Street 1:1466 SAX LEIGH DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-6913
Practice Address - Country:US
Practice Address - Phone:214-375-0837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2948101YP2500X
TX110101YP2500X
216808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110OtherLICENSE PROFESSIONAL COUN
LA2948OtherLICENSE PROFESSIONAL COUN
216808OtherNAT'L BOARD CERT COUNSELO