Individual provider Active NPI

Jane Ellen Davis, LCSW

  • Clinical Social Worker
  • Niceville, FL
National Provider Identifier
1659764694
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12598 Issued in FL
Practice address
4591 E Highway 20 Ste 202I
Niceville, FL 32578-8845
Phone
(850) 333-6828
NPI assigned
Mar 16, 2015
Last updated
Mar 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12598 FL Primary

Addresses

Primary practice location

4591 E Highway 20 Ste 202I
Niceville, FL 32578-8845

Mailing address

4591 E Highway 20 Ste 202I
Niceville, FL 32578-8845
Phone (850) 333-6828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150516000107 FL Practitioner - Clinical Social Worker 4688994593 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12598FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Breeze Counseling, PLLC Clinical CurrentSince Mar 10, 2023 Accepting new patients

Locations

4516 E Highway 20
Niceville, FL 32578
Phone (448) 256-6190

4591 E Highway 20
Ste 2021
Niceville, FL 32578
Phone (850) 333-6828

4591 E Highway 20
Ste 202I
Niceville, FL 32578
Phone (850) 333-6828

Organizations & group practices 1

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": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1659764694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4591 E HIGHWAY 20 STE 202I",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788845",
            "telephone_number": "850-333-6828",
            "fax_number": "850-520-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4591 E HIGHWAY 20 STE 202I",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788845",
            "telephone_number": "850-333-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JANE",
        "middle_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

Verify at the official NPI Registry.