Jessica Marie Davila, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

005443 Issued in CT

Practice address

125 Penfield Rd
Fairfield, CT 06824-6611

Phone

(203) 255-5777

Fax

(203) 259-9673

NPI assigned

Feb 14, 2022

Sex

Female

Sole proprietor

Yes

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

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifebridge Community Services, IncGroup PAC ID 4981595618, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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

• Lifebridge Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bridgeport, CT
  • NPI 1922006923
  Medicare reassignment Care Compare group NPD
• Green Lotus Therapy PLLC

  • Professional Counselor
  • Bridgeport, CT
  • NPI 1972434447
  NPD Authorized official
• Lifebridge Community Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fairfield, CT
  • NPI 1750378667
  NPD

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1780339200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 CLINTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051700",
            "telephone_number": "203-255-5777",
            "fax_number": "203-259-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 PENFIELD RD",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068246611",
            "telephone_number": "203-255-5777",
            "fax_number": "203-259-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4145",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "005443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Garrell, M.D. LLC
• David J Wohl DDS, PC
• Shane Davido-Da Silva, LMSW-CC
• Abigail S. Davies, OT
• Michaela Davies, PA-C
• Jon Gregory Davis, D.M.D.
• Robert V Dawe, MD
• Catherine Susan Day, PT MHS
• Ludivine De Cambourg, LPCA
• Skylar R De Vito, PA-C

• Professional Counselor in Fairfield, CT
• Providers in Fairfield, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.