JEREMY KEITH DAVIS (NPI# 1518208206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518208206 |
| Entity Type | Individual |
| Full Name | JEREMY KEITH DAVIS |
| Credential | LPCC, LPC, LADC, SAC |
| Practice Address |
8200 Humboldt Ave S Ste 100 Bloomington MN 55431-1433 |
| Mailing Address |
405 Stageline Rd Hudson WI 54016-1793 |
| Practice Telephone | 9524540421 |
| Mailing Telephone | 7155316000 |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2019-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15822-131 | WI | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
305108 | MN | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
5690-125 | WI | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
2076 | MN | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 405 Stageline Rd, Hudson, WI 540167848 | 7155316000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013291210 | Jeremy Davis | Pharmacist | 9285 Halls Ferry Rd., Jennings, MO 63136 | 2011-10-06 |
| 1538156062 | Jeremy Franklin Davis | Podiatrist | 335 E Waterloo Rd, Akron, OH 44319-1218 | 2005-09-30 |
| 1205464476 | Jeremy Davis | Student in an Organized Health Care Education/Training Program | 1 Childrens Way # 512-19a, Little Rock, AR 72202-3500 | 2020-03-31 |
| 1013549476 | Jeremy Troy Davis | Student in an Organized Health Care Education/Training Program | 1025 Atlantic Ave, Alameda, CA 94501-1189 | 2020-02-04 |
| 1407418957 | Jeremy L. Davis | Nurse Practitioner | 50 Harrison St Ste 212f, Hoboken, NJ 07030-6087 | 2019-07-05 |
| 1548720162 | Jeremy P Davis | Student in an Organized Health Care Education/Training Program | 1900 10th Ave Ste 100, Columbus, GA 31901-3601 | 2019-03-20 |
| 1316426521 | Jeremy Davis | Social Worker | 1744 Payne Ave, Cleveland, OH 44114-2910 | 2018-08-08 |
| 1982055620 | Jeremy Davis | Pharmacist | 164 E Main St, Rexburg, ID 83440-1912 | 2016-06-23 |
| 1760832927 | Jeremy Davis | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2016-06-20 |
| 1538599642 | Jeremy Davis | Social Worker | 919 Lawyers Ln, Columbus, GA 31906-3129 | 2013-11-26 |
| Street Address |
8200 HUMBOLDT AVE S STE 100 |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55431-1433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770131476 | Ayan A Haga I | Behavior Technician | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2019-08-27 |
| 1205484821 | Tavares Euells | Behavior Technician | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2019-08-27 |
| 1235787946 | Nimo A Mohamud | Behavior Technician | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2019-08-27 |
| 1881241883 | Amira Said Abdullahi | Behavior Technician | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2019-08-23 |
| 1063069078 | Dekha Abdi Ali | Behavioral Analyst | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2019-08-23 |
| 1003468901 | Hanan Aweys Hassan | Behavior Technician | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431 | 2019-07-10 |
| 1609348549 | Maryam Hassan Abtidon | Counselor | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2018-12-17 |
| 1922579119 | Erin Michelle Freshwater | Counselor | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2018-12-16 |
| 1295206878 | David Aurelio Jara | Counselor | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2018-12-08 |
| 1780153809 | Collette C Gboweh | Counselor | 8200 Humboldt Ave S Ste 100, Bloomington, MN 55431-1433 | 2018-11-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1760042253 | Adams Health Care Services, LLC | Registered Nurse | 10036 Washburn Ave S, Bloomington, MN 55431 | 2019-06-17 |
| 1851864755 | Hope Autism Center | Day Training, Developmentally Disabled Services | 9333 Penn Ave S, Bloomington, MN 55431 | 2019-01-03 |
| 1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
| 1497240469 | Mikayla Slegh | Behavior Technician | 8200 Humboldt Ave S Suite 100, Bloomington, MN 55431 | 2018-06-22 |
| 1073061552 | David Wells | Nurse Practitioner | 8100 Northland Dr., Bloomington, MN 55431 | 2016-09-14 |
| 1780033076 | Yasin Jama | Contractor | 9810 Drew Avenue South, Apartment 106, Bloomington, MN 55431 | 2016-06-07 |
| 1972961001 | Kadar Hadis | Social Worker | 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431 | 2016-02-03 |
| 1063878908 | Amazing Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 9031 Penn Ave South Suite 100, Bloomington, MN 55431 | 2016-01-07 |
| 1093170136 | Kelsey Margaret Perreault | Chiropractor | 8120 Penn Ave. S., Suite 525, Bloomington, MN 55431 | 2015-12-16 |
| Find all providers in zip 55431 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013526631 | Sandra Clark | Counselor | 205 N College Avenue, Suite 210a, Bloomington, IN 47404 | 2020-07-29 |
| 1881218642 | Amy Lynn Hootman | Counselor | 2806 W Fawkesway Dr, Bloomington, IN 47404-1211 | 2020-06-07 |
| 1568096543 | Elm Services LLC | Counselor | 4076 N Brookwood Dr, Bloomington, IN 47404-9602 | 2020-02-27 |
| 1033759014 | Joseph Gerbofsky | Counselor | 410 S Landmark Ave, Bloomington, IN 47403-5000 | 2020-01-08 |
| 1508416371 | Amy Michelle Owens | Counselor | 400 W 7th St Ste 105g, Bloomington, IN 47404-3900 | 2019-09-13 |
| 1407401714 | Nichole M Day | Counselor | 101 W Kirkwood Ave Ste 210, Bloomington, IN 47404-6133 | 2019-08-04 |
| 1548721574 | Ashley Hilkey | Counselor | 4500 W Woodland Dr, Bloomington, IN 47404-9582 | 2019-03-31 |
| 1235695867 | Sandra K. Tucker, Ms, Lmhc, LLC | Counselor | 822 W 1st St Ste 4, Bloomington, IN 47403-2382 | 2019-02-19 |
| 1487120903 | Rebecca Anne Romberger | Counselor | 530 W Center, Bloomington, IL 61701-6170 | 2018-10-23 |
| 1740789635 | Jonna Marie Capio Lmhc LLC | Counselor | 3925 E Hagan St Ste 307, Bloomington, IN 47401-8649 | 2018-02-06 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55431 |
Please comment or provide details below to improve the information on JEREMY KEITH DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.