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General NPI Number Information
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NPI Number | 1972033579
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Entity Type | Organization
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Legal Business Name | DAVENPORT & ASSOCIATES COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 06/15/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 22020 GREATER MACK AVE.
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City | ST. CLAIR SHORES
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State | MI
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Zip | 48080-2369
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Country | US
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Telephone | 313-559-2013
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Fax |
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Provider Business Mailing Address
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Address Line | 22020 GREATER MACK AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2369
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Country | US
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Telephone | 313-559-2013
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Fax |
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Authorized Official
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Title or Position | COUNSELOR/OWNER
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Name | SAMEERAH DAVENPORT
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Credential | PHD
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Telephone | 313-559-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401010707
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License Number State | MI
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