Provider Demographics
NPI:1326738444
Name:DEVON DAVASHER, LCSW PLLC
Entity Type:Organization
Organization Name:DEVON DAVASHER, LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:DAVASHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CCM
Authorized Official - Phone:501-291-0420
Mailing Address - Street 1:6834 CANTRELL RD # 2267
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4135
Mailing Address - Country:US
Mailing Address - Phone:501-291-0420
Mailing Address - Fax:866-728-9492
Practice Address - Street 1:701 SOUTH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653
Practice Address - Country:US
Practice Address - Phone:501-291-0420
Practice Address - Fax:866-728-9492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health