Jaquavia Lynn Demus, LBSW, LCDC, LPC
Individual provider Active NPI Mental Health Counselor · Rosharon, TX
NPI 1003586595 · NPPES record last updated Jun 2, 2025
Key facts
- NPI
- 1003586595
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 91346 (TX)
- Practice address
- 1928 Acklen Run Dr
Rosharon, TX 77583-2901 - Phone
- (346) 775-1129
- NPI assigned
- Sep 15, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91346 | TX | MD | Mental Health Counselor |
| 61809 | TX | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 61809 | TX | |
| Mental Health Counselor | 101YM0800X | 91346 | TX | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15954 | TX |
Addresses
Primary practice location
1928 Acklen Run Dr
Rosharon, TX 77583-2901
Mailing address
1928 Acklen Run Dr
Rosharon, TX 77583-2901
Phone (346) 775-1129
Other providers in Rosharon, TX
- Customized Wellness LLC
- CVS Pharmacy Inc
- CVS Pharmacy Inc
- Shirley Daniels
- Shane Davison
- Izonderera Dieudonne
- Divine Signature Inc
- Dolphine Healthcare Services Inc
- Rainier Christopher Doria
- Drovin Tours & Logistics LLC
All providers in Rosharon, TX · Mental Health Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.