Provider Demographics
NPI:1821638743
Name:DAVIS, JAYME LYNNE (LPC)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:LYNNE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 344
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SD
Mailing Address - Zip Code:57769-0344
Mailing Address - Country:US
Mailing Address - Phone:605-349-3162
Mailing Address - Fax:
Practice Address - Street 1:501 E SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-3901
Practice Address - Country:US
Practice Address - Phone:605-349-3162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-08
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC20520101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor