Organization
DAVIS-SMITH MENTAL HEALTH PROVIDER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA NICHOLE DAVIS LCPC (PRESIDENT/COUNSELOR)
(309) 696-7584
Entity
Organization
Contact information
Practice address
100 BATSON CT STE 206, NEW LENOX, IL 60451-1565
(309) 696-7584
Mailing address
14453 STATELY OAKS CIR, HOMER GLEN, IL 60491-9394
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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