person
Jerry Davenport, LAC
Addiction (Substance Use Disorder) Counselor in Girard, Kansas
NPI 1043579725

Jerry Davenport is an Addiction (Substance Use Disorder) Counselor based in Pittsburg, KS and is specialized in Addiction (Substance Use Disorder). Jerry Davenport practices in Girard, KS and has the professional credentials of LAC. The NPI Number for Jerry Davenport is 1043579725 and holds a License No. 461 (Kansas).

The current practice location address for Jerry Davenport is 810 Cedar St, Girard, KS and can be reached out via phone at 620-724-8806 and via fax at 620-724-6170.

Location: 810 Cedar St, Girard, KS, 66762-6601
person
Provider Profile Details
NPI Number
1043579725
Provider Name
Jerry Davenport
Credential
LAC
Provider Entity Type
Individual
Gender
Male
Address
810 Cedar St, Girard, KS, 66762-6601
Phone Number
620-724-8806
Fax Number
620-724-6170
Provider Enumeration Date
05/15/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
810 Cedar St
City
State
Zip
66743-2056
Phone Number
620-724-8806
Fax Number
620-724-6170
person
Provider Business Mailing Address Details
Address
810 Cedar St
City
State
Zip
66743-2056
Phone Number
620-724-8806
Fax Number
620-724-6170
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
461 (Kansas)
Definition
Definition to come...
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