Jacqueline Davis, Licensed Professional Clinical Counselor, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

JACQUELINE DAVIS, LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC.

Practice address

32759 1/8 Birch Hill Road
Palomar Mountain, CA 92060

Phone

(760) 651-2881

NPI assigned

Jan 19, 2024

Last updated

Jan 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacqueline Davis, LPCCNPI 1871842872

Title

Counselor/Owner

Phone

(760) 651-2881

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacqueline Davis, LPCC

  • Mental Health Counselor
  • Palomar Mountain, CA
  • NPI 1871842872
  Authorized official Same address or phone

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1396506176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "PALOMAR MOUNTAIN",
            "state": "CA",
            "postal_code": "920600115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32759 1/8 BIRCH HILL ROAD",
            "city": "PALOMAR MOUNTAIN",
            "state": "CA",
            "postal_code": "92060",
            "telephone_number": "760-651-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELINE DAVIS, LICENSED PROFESSIONAL CLINICAL COUNSELOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "COUNSELOR/OWNER",
        "authorized_official_telephone_number": "760-651-2881",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Davis, LPCC

• Mental Health Counselor in Palomar Mountain, CA
• Providers in Palomar Mountain, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.