Individual provider Active NPI

Devon Brandon Davasher, LCSW, CCM

  • Clinical Social Worker
  • Bentonville, AR
National Provider Identifier
1568895795
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6894-C Issued in AR
Practice address
1200 SE 14TH St
Ste 8 PMB 303
Bentonville, AR 72712-7997
Phone
(501) 291-0420
NPI assigned
Aug 12, 2013
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2016014769 MO
Clinical Social Worker 1041C0700X 5587 OK
Clinical Social Worker 1041C0700X CSW.09932963 CO
Clinical Social Worker 1041C0700X 6894-C AR Primary

Addresses

Primary practice location

1200 SE 14TH St
Ste 8 PMB 303
Bentonville, AR 72712-7997

Mailing address

1200 SE 14TH St Ste 8
Bentonville, AR 72712-7997
Phone (501) 291-0420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR, MO3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20221102002480 OK Practitioner - Clinical Social Worker 3870960982 Reassigns benefits to 1 organization
I20230601002278 AR Practitioner - Clinical Social Worker 3870960982 Reassigns benefits to 1 organization
I20230626002809 MO Practitioner - Clinical Social Worker 3870960982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Stillwater, OK 74074
Phone (501) 291-0420

6834 Cantrell Rd
Suite 2267
Little Rock, AR 72207-4135
Phone (501) 291-0420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5587OKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Devon Davasher, LCSW PLLC CurrentSince Apr 1, 2023 Accepting new patients

Locations

1200 SE 14th St
Ste 8
Bentonville, AR 72712
Phone (479) 273-1803

6834 Cantrell Rd
Little Rock, AR 72207
Phone (501) 291-0420

701 South St
Ste 100
Mountain Home, AR 72653
Phone (309) 665-0206

3605 Missouri Blvd
Jefferson City, MO 65109
Phone (501) 291-0420

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1568895795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SE 14TH ST STE 8",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127997",
            "telephone_number": "501-291-0420",
            "fax_number": "866-728-9492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SE 14TH ST",
            "address_2": "STE 8 PMB 303",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727127997",
            "telephone_number": "501-291-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVASHER",
        "first_name": "DEVON",
        "middle_name": "BRANDON",
        "credential": "LCSW, CCM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-12",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016014769",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "5587",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09932963",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "6894-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.