Provider Demographics
NPI:1689703985
Name:DAVIS, JANA KAY (LCSW)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:KAY
Other - Last Name:LENEAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8009 ELAINE CT
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-3004
Mailing Address - Country:US
Mailing Address - Phone:618-315-9464
Mailing Address - Fax:
Practice Address - Street 1:8009 ELAINE CT
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-3004
Practice Address - Country:US
Practice Address - Phone:618-315-9464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040082541041C0700X
IL1490125661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical