Provider Demographics
NPI:1952618787
Name:DAVIS, JAMES JAY (CMHC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JAY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1379 N 1075 W STE 228
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2859
Mailing Address - Country:US
Mailing Address - Phone:801-872-8052
Mailing Address - Fax:
Practice Address - Street 1:475 N 300 W STE 14
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-3110
Practice Address - Country:US
Practice Address - Phone:801-872-8052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-31
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11146588-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health