=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952897522
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JHIREE DAVIS-JONES LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2018
-----------------------------------------------------
Last Update Date | 07/07/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 FOREST AVE STE 8
-----------------------------------------------------
City | PARAMUS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07652-5238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 551-206-0664
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 135 CARBON ST APT 2
-----------------------------------------------------
City | PATERSON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07522-1228
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 551-206-0664
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 37PC00636200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------