Mariquena Edith Davenport, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C017965 Issued in NC

Practice address

140 N Steele St Ste 5
Sanford, NC 27330-3967

Phone

(919) 253-5396

NPI assigned

Dec 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Mariposa Therapeutic Services PLLC

  • Clinical Social Worker
  • Sanford, NC
  • NPI 1174212096
  NPD
• A New Leaf Therapeutic Services, PLLC

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1710391867
  NPD (past)
• Victory Family Counseling

  • Clinical Social Worker
  • Concord, NC
  • NPI 1063000610
  NPD (past)

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735948800000",
    "number": "1427520105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 N STEELE ST STE 5",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303967",
            "telephone_number": "919-253-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N STEELE ST STE 5",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303967",
            "telephone_number": "919-253-5396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "MARIQUENA",
        "middle_name": "EDITH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2025-01-04",
        "certification_date": "2025-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanne Q Crupi, PT
• Linda Marie Curd, PTA
• Ali Cyca, PHARMD
• Kim D. Dansie, MD
• Uma Sunny Darji, MD
• David a Edrington DDS PA
• Crystal Davidson
• Harmony Davidson
• Krishawn Davis-Darby
• Kaylee Davis

• Clinical Social Worker in Sanford, NC
• Providers in Sanford, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2025; 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.