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General NPI Number Information
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NPI Number | 1568895795
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Entity Type | Individual
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Provider Name | DEVON BRANDON DAVASHER LCSW, CCM
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Gender | Male
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 1200 SE 14TH ST STE 8 PMB 303
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City | BENTONVILLE
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State | AR
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Zip | 72712-7997
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Country | US
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Telephone | 501-291-0420
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 SE 14TH ST STE 8 #303
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City | BENTONVILLE
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State | AR
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Zip | 72712-7997
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Country | US
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Telephone | 501-291-0420
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Fax | 866-728-9492
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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 | 5587
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6894-C
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License Number State | AR
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