Hollie Stewart Davenport, LCSW

Key facts

NPI

1619681202

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Social Worker 1041C0700X

License

7142 (TN)

Practice address

Corner of Lamont & Veterans Way
Building 160
Mountain Home, TN 37684-6000

Phone

(423) 926-1171

Fax

(423) 979-2645

NPI assigned

Jan 9, 2023

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 9, 2023.

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1619681202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6000",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376846000",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF LAMONT & VETERANS WAY",
            "address_2": "BUILDING 160",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376846000",
            "telephone_number": "423-926-1171",
            "fax_number": "423-979-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "HOLLIE",
        "middle_name": "STEWART",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, TN

• Callie Crockett
• Sydney Myles Crockrell, LMSW
• Katelyn Cserjes, MD
• Della C Cutchins, PHARMD
• Richard Cutlip, PHARM.D.
• Wilma Mae Davenport, L.C.S.W.
• Melissa Sam Davis, LMSW
• Megan Day, FNP
• Donita Lynne Denton, S.W.
• Mark Alan Depew

All providers in Mountain Home, TN · Clinical Social Worker in Tennessee