Individual provider Active NPI

Jane Maria Davis

  • Mental Health Counselor
  • Ithaca, NY
National Provider Identifier
1639945090
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
014076 Issued in NY
Practice address
127 W State St
Ithaca, NY 14850-5474
Phone
(607) 273-7494
NPI assigned
Nov 28, 2023
Last updated
May 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 014076 NY Primary

Addresses

Primary practice location

127 W State St
Ithaca, NY 14850-5474

Mailing address

127 W State St
Ithaca, NY 14850-5474
Phone (607) 273-7494

Other practice location 1

3635 Bell Blvd Ste 203
Bayside, NY 11361-2097
Phone (718) 504-9256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627002744 NY Practitioner - Mental Health Counselor 7911441233 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Counseling LCSW PLLCGroup PAC ID 3870754427, 46 clinicians

Practice addresses (Care Compare)

3635 Bell Blvd
Suite 203
Bayside, NY 11361-2097
Phone (718) 830-0246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014076NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC Mental Health CurrentSince Aug 6, 2024 Accepting new patients
Family and Children Services of Ithaca PastSince Dec 3, 2023 Accepting new patients

Locations

2 Main St
Ste 2A
Plymouth, MA 02360

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone 7185049256 ext. 49256

50 Fountain Plz
Ste 1400
Buffalo, NY 14202
Phone (718) 504-9256

1129 Northern Blvd
Ste 404
Manhasset, NY 11030
Phone (516) 305-5531

57 W 57th St
Frnt 3
New York, NY 10019

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1639945090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 W STATE ST",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148505474",
            "telephone_number": "607-273-7494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3635 Bell Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Bayside",
            "state": "NY",
            "postal_code": "113612097",
            "country_code": "US",
            "telephone_number": "718-504-9256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JANE",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ithaca, NY

Sources for this page

Verify at the official NPI Registry.