Olivia Davenport

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6555 Issued in CT

Practice address

6 Ledgebrook Dr FL 2
Mansfield Center, CT 06250-1644

Phone

(860) 833-2657

NPI assigned

Dec 9, 2024

Last updated

Dec 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Bellevue Hospital Medical College, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Change Counseling, LLC

  • Clinical Social Worker
  • Willimantic, CT
  • NPI 1780141465
  Medicare reassignment NPD

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1083420640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LEDGEBROOK DR",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 LEDGEBROOK DR FL 2",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501644",
            "telephone_number": "860-833-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "6555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate D'Addabbo, LCSW
• Fabiana Aretusa Da Silva, LCSW
• Karen Ann Daly, M.D.
• Danielle N. Christian, LCSW, LLC
• Kristy Victoria Davenport, REGISTERED NURSE
• David Henry, PH.D.
• Susan Davis, DMD
• Khara Lee Dean, RN
• Francis Anthony Degennaro III, PHYSICAL THERAPIST
• Irene J. Demers, LCSW

• Mental Health Counselor in Mansfield Center, CT
• Providers in Mansfield Center, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.