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General NPI Number Information
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NPI Number | 1396804548
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Entity Type | Individual
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Provider Name | LARRY C DAVENPORT LMHC
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 2020 BROWN ST
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City | ANDERSON
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State | IN
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Zip | 46016-4218
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Country | US
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Telephone | 317-574-1254
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Fax | 317-674-0060
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Provider Business Mailing Address
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Address Line | 9615 E 148TH ST STE 1
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City | NOBLESVILLE
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State | IN
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Zip | 46060-4371
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Country | US
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Telephone | 317-587-0500
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Fax | 317-674-0060
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 39001264A
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License Number State | IN
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