MEDICARE: INNER ROOTS BEHAVIORAL HEALTH PLLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1437027976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER ROOTS BEHAVIORAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	123 N MAIN ST STE 107
Second Line	:
City	:	LORETTO
State	:	TN
Zip	:	38469-2356
Country	:	US
Telephone Number	:	931-223-6659
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 N MAIN ST STE 107
Second Line	:
City	:	LORETTO
State	:	TN
Zip	:	38469-2356
Country	:	US
Telephone Number	:	931-223-6659
Fax Number	:

Authorized Official
Title or Position	:	OWNER & MANAGING MEMBER
Name	:	NIKKI LEE DAVENPORT
Credential	:	PMHNP-BC, FNP-C, DNP
Telephone Number	:	931-242-9298

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	03/10/2026

Similar Medicare Providers

1174522007 — MS. EMILY V GILLESPIE MSN, FNP
Practice Location Address:

722 N. MILITARY AVE.
LORETTO, TN
38469

Practice Phone: 931-853-6970
Practice Fax: 931-853-6974

1316902760 — MRS. NICOLE TUCKER MCCONNELL PHARMD
Practice Location Address:

106 CHURCH ST
LORETTO, TN
38469-2143

Practice Phone: 931-853-5910
Practice Fax: 931-853-5930

1891753117 — DR. RUFUS G HARMON PHD
Practice Location Address:

534 N MILITARY ST
LORETTO, TN
38469

Practice Phone: 931-853-7421
Practice Fax: 931-853-7451

1427096262 — DR. MATTHEW E. SCHANTZ M.D.
Practice Location Address:

206 S MILITARY ST
LORETTO, TN
38469-2101

Practice Phone: 931-853-6136
Practice Fax: 931-853-6137

1043225675 — LORETTO DRUGS L L C
Practice Location Address:

106 CHURCH ST
LORETTO, TN
38469-2143

Practice Phone: 931-853-5910
Practice Fax: 931-853-5930

1659514776 — AMG CROCKETT LLC
Practice Location Address:

106 S MILITARY AVE
LORETTO, TN
38469-2101

Practice Phone: 931-853-4622
Practice Fax: 931-853-4621

Directions to “INNER ROOTS BEHAVIORAL HEALTH PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.