Healthcare Provider Details

I. General information

NPI: 1518291806
Provider Name (Legal Business Name): PEYTON & DAVENPORT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2009
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6770 DIXIE HWY STE 314
CLARKSTON MI
48346-5114
US

IV. Provider business mailing address

3153 HENDERSON LAKE RD
PRESCOTT MI
48756-9338
US

V. Phone/Fax

Practice location:
  • Phone: 248-568-4524
  • Fax: 888-375-2104
Mailing address:
  • Phone: 248-568-4524
  • Fax: 888-375-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. LYN PEYTON
Title or Position: PRESIDENT
Credential: MA, LLP
Phone: 248-568-4524