Provider Demographics
NPI:1184613457
Name:DAVENPORT, RONALD D (MED, LPC, CEAP)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:D
Last Name:DAVENPORT
Suffix:
Gender:M
Credentials:MED, LPC, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ROCKMEAD DR
Mailing Address - Street 2:SUITE 270
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-5018
Mailing Address - Country:US
Mailing Address - Phone:281-359-3283
Mailing Address - Fax:281-913-1850
Practice Address - Street 1:700 ROCKMEAD DR
Practice Address - Street 2:SUITE 270
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5018
Practice Address - Country:US
Practice Address - Phone:281-359-3283
Practice Address - Fax:281-913-1850
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional