Provider Demographics
NPI:1275866394
Name:DAVENPORT, SARAH CAPRI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:CAPRI
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 SADDLECREEK CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-1962
Mailing Address - Country:US
Mailing Address - Phone:502-415-1652
Mailing Address - Fax:
Practice Address - Street 1:1329 APPLEGATE LANE
Practice Address - Street 2:SOUTHERN INDIANA REHAB HOSPITAL
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129
Practice Address - Country:US
Practice Address - Phone:812-283-7908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042366A103TC0700X
KY1556103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical