Davis, Jackalyn Leigh

Davis, Jackalyn Leigh is an sole proprietor health care provider with primary practice located at 2126 N 1St St Suite F, Jacksonville AR 72076-2868. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Davis, Jackalyn Leigh can be contacted via phone (501) 982-5000.

Contact Information

Primary practice address
2126 N 1St St Suite F Jacksonville AR 72076-2868
Phone: (501) 982-5000
Fax: (501) 982-5007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X A1708271 Arkansas
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Professional 101YP2500X P2203005 Arkansas

Profile Details

NPI number 1710237581
LBN Legal business name Davis, Jackalyn Leigh
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 19th, 2012
Last updated Mar 23rd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710237581 NPPES
Arkansas MEDICAID 193514795

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