Individual
JAY POWELL DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, ADCLAD
Contact information
Practice address
1017 W MARKET ST, LOUISVILLE, KY 40202-2630
(502) 357-1986
(502) 587-9565
Mailing address
1020 W MARKET ST, LOUISVILLE, KY 40202-2630
(502) 584-7844
(502) 587-9565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00223665
KY
1041C0700X
Clinical Social Worker
0875
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0875
KENTUCKY BOARD OF SOCIAL WORK
KY
Enumeration date
02/01/2017
Last updated
03/07/2023
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