Jaclyn Marie Davis, MA/CAS
Individual provider Active NPI School Psychologist · Homer, NY
NPI 1366190829 · NPPES record last updated Mar 14, 2022
Key facts
- NPI
- 1366190829
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 965888151 (NY)
- Practice address
- 9 Central Park Place
Homer, NY 13077 - Phone
- (607) 749-1250
- NPI assigned
- Mar 14, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 965888151 | NY | MD | School Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | NY | ||
| School Psychologist | 103TS0200X | 965888151 | NY | Yes |
Addresses
Primary practice location
9 Central Park Place
Homer, NY 13077
Mailing address
453 Surrey Dr
Cortland, NY 13045-9378
Phone (607) 342-4378
Other providers in Homer, NY
- Danielle Angelique Craft
- Lois Anne Creighton
- Patricia J Curtin
- Rebecca Jane Cutler
- Maximo Jose D'Oleo
- Jodie Lynn Delage
- Department of Medicine Medical Service Group
- Jamie Lynn Driscoll
- Heidi Jean Effinger
- Elizabeth Brewster House
All providers in Homer, NY · School Psychologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 14, 2022. 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.