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General NPI Number Information
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NPI Number | 1528339009
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Entity Type | Individual
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Provider Name | JEFFREY PETER DAVIS LMSW-C
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Gender | Male
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Dates
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Enumeration Date | 01/16/2012
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 132 N MAIN ST UNIT A
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City | ADRIAN
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State | MI
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Zip | 49221-2729
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Country | US
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Telephone | 517-403-3738
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Fax | 517-265-1903
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Provider Business Mailing Address
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Address Line | 4765 HOOKS MILL RD
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City | ADRIAN
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State | MI
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Zip | 49221-9410
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Country | US
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Telephone | 517-403-3738
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Fax | 517-266-8881
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801117470
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License Number State | MI
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