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Individual
MR. JERRY DAVIS-EL
Active
Individual
MR. JERRY DAVIS-EL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
29962
IL
1041C0700X
Clinical Social Worker
Primary
29962
IL
Other
Enumeration date
04/05/2018
Last updated
01/23/2026
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