Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jaeren Anthony Davis, LICSW, QMHP-C

Individual provider Counselor · NPI 1386047884

Jaeren Anthony Davis, LICSW, QMHP-C is a Counselor in Vancouver, Washington. Works from 2 locations. Licensed in Oregon and Washington.

Licensed in
OR, WA
In the registry since
2014
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

400 NE Mother Joseph Pl
Vancouver, WA 98664-3200
Phone: (360) 256-2000
Fax: (360) 514-2548
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 33 Nw Broadway, Portland, OR 97209-3580 — (503) 228-7134

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LW61031767 (WA)
Counselor Taxonomy 101Y00000X · Licence THW00071 (OR)

Record details

NPI number1386047884
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW , QMHP-C
Sole proprietorNo
NPI enumeratedSeptember 29, 2014
Last updated in NPPESJanuary 17, 2024
Certification dateJanuary 17, 2024

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