Susan F Davenport PHD Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1969 Issued in GA

Legal business name

SUSAN F DAVENPORT PHD INC

Practice address

121 Carl Vinson Parkway
Warner Robins, GA 31088

Phone

(478) 922-2365

Fax

(478) 922-1778

NPI assigned

Apr 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Susan F Davenport, PHD

Title

Owner

Phone

(478) 922-2365

Specialties & licenses 1

Addresses

Other names 1

• Dr Susan F Davenport Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043332778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CARL VINSON PARKWAY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-922-2365",
            "fax_number": "478-922-1778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CARL VINSON PARKWAY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "31088",
            "telephone_number": "478-922-2365",
            "fax_number": "478-922-1778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN F DAVENPORT PHD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-922-2365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "1969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Susan F Davenport",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Psychologist in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.