Davis, Jeremy Keith

Davis, Jeremy Keith is an individual health care provider with primary practice located at 8200 Humboldt Ave S Ste 100 , Bloomington MN 55431-1433. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Davis, Jeremy Keith can be contacted via phone (952) 454-0421.

Contact Information

Primary practice address
8200 Humboldt Ave S Ste 100 Bloomington MN 55431-1433
Phone: (952) 454-0421
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 5690-125 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 2076 Minnesota
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 15822-131 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 305108 Minnesota

Profile Details

NPI number 1518208206
LBN Legal business name Davis, Jeremy Keith
Credentials LPCC, LPC, LADC, SAC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2013
Last updated Nov 5th, 2019 - about 7 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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