Davenport, Elizabeth
Davenport, Elizabeth is an individual health care provider with primary practice located at 740 Main St Suite #105, Waltham MA 02451. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Davenport, Elizabeth can be contacted via phone (781) 937-4172.Contact Information
Primary practice address
740 Main St Suite #105
Waltham MA 02451
Phone: (781) 937-4172
Fax: (781) 734-0482
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 100214 | Massachusetts |
Profile Details
| NPI number | 1497818116 |
|---|---|
| LBN Legal business name | Davenport, Elizabeth |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497818116 | NPPES |
| Other | P04346 | BLUE CROSS BLUE SHIELD |
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