Basic Information
Provider Information
NPI: 1780709410
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAVENPORT
FirstName: APRIL
MiddleName: S
NamePrefix: MS.
NameSuffix:  
Credential: B.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 755 MONTCLAIR DR APT 6
Address2:  
City: CLAYMONT
State: DE
PostalCode: 197033638
CountryCode: US
TelephoneNumber: 2155680860
FaxNumber:  
Practice Location
Address1: 112 N BROAD ST
Address2:  
City: PHILA
State: PA
PostalCode: 191021510
CountryCode: US
TelephoneNumber: 2155680860
FaxNumber: 2155680769
Other Information
ProviderEnumerationDate: 03/20/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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