Jill Susan Davis, M.ED., LBS

Primary specialty

CounselorTaxonomy code 101Y00000X

License

BH004015 Issued in PA

Practice address

1114 Whipple Way
Ambler, PA 19002-1196

Phone

(215) 692-0289

NPI assigned

Nov 10, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1043928856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 WHIPPLE WAY",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190021196",
            "telephone_number": "215-692-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 WHIPPLE WAY",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190021196",
            "telephone_number": "215-692-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JILL",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "M.ED., LBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "BH004015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.indcreek.org",
            "affiliation": "N",
            "address_1": "420 Cowpath Rd",
            "city": "Souderton",
            "state": "PA",
            "country_code": "US",
            "postal_code": "189642036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shannon Dade
• Melynda Kristine Dahl, CRNP, RN
• Dale V Sinker MD LTD
• Richard Davies
• Shawn Davies
• M. Pia De Girolamo, MD
• Hannah De Groot
• Julia Nicole Dececco, RD
• Steven E Decker, MD
• Catherine E Delaurentis

• Counselor in Ambler, PA
• Providers in Ambler, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.