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NPI Code Detail

MEDICARE: DR. MALINDA DAVENPORT-CRISP PHD, LPC/MHSP

MEDICARE:  DR. MALINDA  DAVENPORT-CRISP  PHD, LPC/MHSP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2835TN

General Provider Information

NPI Number : 1073921656
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MALINDA DAVENPORT-CRISP PHD, LPC/MHSP
Provider Business Mailing Address
First Line : 417 WELSHWOOD DR STE 303
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-4248
Country : US
Telephone Number : 615-554-5075
Fax Number :
Provider Business Practice Location Address
First Line : 417 WELSHWOOD DR STE 303
Second Line :
City : NASHVILLE
State : TN
Zip : 37211-4248
Country : US
Telephone Number : 615-554-5075
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2014
Last Update Date : 09/15/2025

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Directions to “ DR. MALINDA DAVENPORT-CRISP PHD, LPC/MHSP” Practice Location

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