Jessie Davis, LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

JESSIE DAVIS, LLC

Practice address

103 E 2ND St Apt 3
Frederick, MD 21701-7200

Phone

(301) 606-2858

NPI assigned

Jan 29, 2022

Organization subpart

No

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

Authorized official

Name

Jessie Davis, LCSW-CNPI 1528436078

Title

Therapist

Phone

(301) 606-2858

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessie Davis, LCSWC

  • Social Worker
  • Frederick, MD
  • NPI 1528436078
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1643414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643414400000",
    "number": "1821741968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E 2ND ST APT 3",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217017200",
            "telephone_number": "301-606-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E 2ND ST APT 3",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217017200",
            "telephone_number": "301-606-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSIE DAVIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-29",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "301-606-2858",
        "authorized_official_credential": "LCSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew James Jepson, M.D., M.S.
• Michelle Lynn Jeram, PT
• Noelly Jerez
• Jerrold J. Pollack,D.D.S.,P.a
• Tyler Merritt Jessee
• Alexa Jo Jessop, LMSW
• Jewel Healthcare Services Inc.
• Jim Rose, LCPC, LLC
• Karla Jimenez
• Shahanawaz Jiwani, M.D., PHD

• Adolescent and Children Mental Health Clinic/Center in Frederick, MD
• Providers in Frederick, MD by specialty
• Adolescent and Children Mental Health Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.