Provider Demographics
NPI:1427843655
Name:JEMISON, LAYCE D (MD)
Entity type:Individual
Prefix:
First Name:LAYCE
Middle Name:D
Last Name:JEMISON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3372 WOOD DRIVE CIR NE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35215-1517
Mailing Address - Country:US
Mailing Address - Phone:205-960-9920
Mailing Address - Fax:
Practice Address - Street 1:1189 ALLBRITTON RD
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-2663
Practice Address - Country:US
Practice Address - Phone:659-266-7587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05162101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor