Provider Demographics
NPI:1568190312
Name:DAVENPORT, KATHERINE (MA, LPCA, NCC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:DAVENPORT
Suffix:
Gender:F
Credentials:MA, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ASHLEY DOWNS
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-2408
Mailing Address - Country:US
Mailing Address - Phone:864-634-9278
Mailing Address - Fax:
Practice Address - Street 1:316 BOULEVARD
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4002
Practice Address - Country:US
Practice Address - Phone:864-231-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7986101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional