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NPI Code Detail

MEDICARE: JESSICA DAVIS BS

MEDICARE:   JESSICA  DAVIS  BS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPLC11218LA
2171M00000XCase Manager/Care CoordinatorLA

General Provider Information

NPI Number : 1972290153
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA DAVIS BS
Provider Business Mailing Address
First Line : 3221 BEHRMAN PL STE 201
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70114-8204
Country : US
Telephone Number : 504-263-2800
Fax Number :
Provider Business Practice Location Address
First Line : 3301 CANAL ST APT 1
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70119-6249
Country : US
Telephone Number : 504-644-2575
Fax Number : 504-644-2803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2023
Last Update Date : 06/01/2026

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