Healthcare Provider Details

I. General information

NPI: 1912002155
Provider Name (Legal Business Name): MARCIA DAVENPORT KENT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 ABBOT RD STE 400
EAST LANSING MI
48823-1900
US

IV. Provider business mailing address

1400 ABBOT RD STE 400
EAST LANSING MI
48823-1900
US

V. Phone/Fax

Practice location:
  • Phone: 517-492-0784
  • Fax: 517-913-6267
Mailing address:
  • Phone: 517-492-0784
  • Fax: 517-913-6267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301070832
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number4301070832
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4301070832
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: