Jacqueline Davis, LPCC is a medicare enrolled "Counselor - Mental Health" provider in Palomar Mountain, California. Her current practice location is
32759 1/8 Birch Hill Road, Palomar Mountain, California. You can reach out to her office (for appointments etc.) via phone at
(760) 651-2881.
Jacqueline Davis is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1871842872.
Healthcare Provider's Profile
| Full Name | Jacqueline Davis |
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| Gender | Female |
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| Speciality | Counselor - Mental Health |
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| Location | 32759 1/8 Birch Hill Road, Palomar Mountain, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1871842872
- Provider Enumeration Date: 09/05/2012
- Last Update Date: 12/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 1254776255
- Enrollment ID: I20240229002698
Medical Identifiers
Medical identifiers for Jacqueline Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871842872 | NPI | - | NPPES |
| 1871842872 | Other | MA | STATE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | 3820 (California) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacqueline Davis allows following entities to bill medicare on her behalf.
| Entity Name | Jacqueline Davis, Licensed Professional Clinical Counselor, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396506176
PECOS PAC ID: 0345685343
Enrollment ID: O20240229002473 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacqueline Davis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacqueline Davis, LPCC
Po Box 115,
Palomar Mountain, CA 92060-0115
Ph: (760) 651-2881 | Jacqueline Davis, LPCC
32759 1/8 Birch Hill Road,
Palomar Mountain, CA 92060
Ph: (760) 651-2881 |
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