Davis, Jeremy Keith
Davis, Jeremy Keith is an individual health care provider with primary practice located at 8200 Humboldt Ave S Ste 100 , Bloomington MN 55431-1433. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Davis, Jeremy Keith can be contacted via phone (952) 454-0421.Contact Information
Primary practice address
8200 Humboldt Ave S Ste 100
Bloomington MN 55431-1433
Phone: (952) 454-0421
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 5690-125 | Wisconsin |
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 2076 | Minnesota |
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 15822-131 | Wisconsin |
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 305108 | Minnesota |
Profile Details
NPI number | 1518208206 |
---|---|
LBN Legal business name | Davis, Jeremy Keith |
Credentials | LPCC, LPC, LADC, SAC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 6th, 2013 |
Last updated | Nov 5th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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