Provider Demographics
NPI:1578631651
Name:VINSON, DAVENY ANN (MS, LPC, MAC)
Entity Type:Individual
Prefix:
First Name:DAVENY
Middle Name:ANN
Last Name:VINSON
Suffix:
Gender:F
Credentials:MS, LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 URBAN CENTER DR STE 600
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2584
Mailing Address - Country:US
Mailing Address - Phone:205-208-9312
Mailing Address - Fax:
Practice Address - Street 1:2010 S POINT PARK CIR APT 190
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5480
Practice Address - Country:US
Practice Address - Phone:256-880-5818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
AL3237101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051528629OtherBCBS OF AL PROVIDER #