Healthcare Provider Details

I. General information

NPI: 1467372771
Provider Name (Legal Business Name): JORDAN DAVIS PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 COURT ST STE 502
BROOKLYN NY
11242-1105
US

IV. Provider business mailing address

49 FLATBUSH AVE # 121
BROOKLYN NY
11217-0464
US

V. Phone/Fax

Practice location:
  • Phone: 215-469-1681
  • Fax:
Mailing address:
  • Phone: 215-469-1681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JORDAN PAIGE DAVIS
Title or Position: DIRECTOR
Credential: PHD
Phone: 215-469-1681