Jessica Lynn Roebuck Davis, LCSW, LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C013322 Issued in NC

Practice address

2300 Rexwoods Dr Ste 140
Raleigh, NC 27607-3361

Phone

(704) 360-3637

NPI assigned

Jun 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Integrative Wellness Solutions, PLLC

  • Psychologist
  • Mooresville, NC
  • NPI 1447760871
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1902336092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 S HORNER BLVD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273305717",
            "telephone_number": "919-718-5408",
            "fax_number": "919-774-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 REXWOODS DR STE 140",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073361",
            "telephone_number": "704-360-3637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 S Horner Blvd",
            "address_purpose": "LOCATION",
            "city": "Sanford",
            "state": "NC",
            "postal_code": "273305717",
            "country_code": "US",
            "telephone_number": "197-185-4089",
            "fax_number": "919-774-3155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "middle_name": "LYNN ROEBUCK",
        "credential": "LCSW, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011552",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013322",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-23854",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George I Davis
• Glenn M Davis, MD
• Jayla Davis
• Jennifer Davis
• Jennifer Lynn Davis
• Jill Davis
• Josie Davis, LPN
• Kathryn Nichole Davis
• Kensleigh Davis, OTR/L, OTD
• Kenya T Davis, LCSW

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.