MEDICARE: MS. JENNIFER HELEN DAVIDSON LMHC

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
1	324500000X	Substance Abuse Rehabilitation Facility	14581	FL

General Provider Information

NPI Number	:	1174168587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER HELEN DAVIDSON LMHC

Provider Business Mailing Address
First Line	:	68 YACHT CLUB DR APT 17
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3934
Country	:	US
Telephone Number	:	561-601-5645
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 YACHT CLUB DR APT 17
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3934
Country	:	US
Telephone Number	:	561-601-5645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2019
Last Update Date	:	11/08/2019

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