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General NPI Number Information
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NPI Number | 1154103299
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Entity Type | Individual
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Provider Name | BARRY DAVENPORT LICSW
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Gender | Male
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Dates
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Enumeration Date | 10/13/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 7841 1ST AVE N
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City | BIRMINGHAM
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State | AL
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Zip | 35206-4354
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Country | US
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Telephone | 256-452-1277
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Fax |
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Provider Business Mailing Address
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Address Line | 1919 OXMOOR RD # 267
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City | HOMEWOOD
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State | AL
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Zip | 35209-3502
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Country | US
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Telephone | 256-452-1277
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5406C
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5406C
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5406C
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License Number State | AL
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