Jimmy Davis, LCDC, LCPC, CFC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

6594 Issued in TX

Practice address

367 Waterfront Row
Quitman, TX 75783-3558

Phone

(214) 463-8142

NPI assigned

Dec 1, 2015

Last updated

Jul 18, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1255705380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 WATERFRONT ROW",
            "city": "QUITMAN",
            "state": "TX",
            "postal_code": "757833558",
            "telephone_number": "214-463-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 WATERFRONT ROW",
            "city": "QUITMAN",
            "state": "TX",
            "postal_code": "757833558",
            "telephone_number": "214-463-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JIMMY",
        "name_prefix": "Dr.",
        "credential": "LCDC, LCPC, CFC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-01",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "6594",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "PA",
            "license": "7347688",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George V Cathey Jr., MD
• Christus Trinity Clinic Texas (Trinity Clinic Quitman)
• Tara Clanton
• Courtney Taylor Crawford, LVN
• David Nichols (All-Nite Sleep Lab)
• Paula Jean Dibenedetto, ARNP
• James Dee Dopson Jr., MD
• East Texas Medical Center
• East Texas Medical Center Healthcare Associates (First Physicians)
• East Texas Medical Center Quitman

• Addiction (Substance Use Disorder) Counselor in Quitman, TX
• Providers in Quitman, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.