Jaclyn Marie Davis, MA/CAS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

965888151 Issued in NY

Practice address

9 Central Park Place
Homer, NY 13077

Phone

(607) 749-1250

NPI assigned

Mar 14, 2022

Last updated

Mar 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1366190829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 SURREY DR",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130459378",
            "telephone_number": "607-342-4378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CENTRAL PARK PLACE",
            "city": "HOMER",
            "state": "NY",
            "postal_code": "13077",
            "telephone_number": "607-749-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JACLYN",
        "middle_name": "MARIE",
        "credential": "MA/CAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "965888151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Rae Courter
• Danielle Angelique Craft, M.A.
• Lois Anne Creighton, LCSW
• Patricia J Curtin, ANP
• Rebecca Jane Cutler, LCSW
• Jodie Lynn Delage, LPN
• Department of Medicine Medical Service Group
• Jamie Lynn Driscoll, LCSW
• Heidi Jean Effinger, LCSW
• Elizabeth Brewster House

• School Psychologist in Homer, NY
• Providers in Homer, NY by specialty
• School Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.