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Contact Information

STACY L DAVENPORT, LCSW
500 OLIVE ST
SUITE 5
MARYSVILLE, CA95901-5637
 Phone: 916-316-5041
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for STACY L DAVENPORT · (Female)

NPI Number 1275628893
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 10/03/2006
Last updated 10/28/2011 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
CA License # LCS 23732
Hospital affiliation(s) n/a
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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