JERRY DAVENPORT LAC NPI 1043579725

NPI Information

  • NPI: 1043579725
  • Provider Name: JERRY DAVENPORT, LAC
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 810 CEDAR ST
    GIRARD, KS
    ZIP 66743
  • Phone: (620) 724-8806

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NPI Details

Jerry Davenport, LAC is an addiction (substance use disorder) counselor in Girard, KS. Jerry Davenport, LAC NPI is 1043579725. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

810 CEDAR ST
GIRARD, KS
ZIP 66743-056
Phone: (620) 724-8806
Fax: (620) 724-6170

The enumeration date for this NPI number is 5/15/2012 and was last updated on 5/15/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)461KANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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