Individual provider Active NPI

Lori Lynn Davenport, LPC

  • Professional Counselor
  • Payson, AZ
National Provider Identifier
1689171654
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-17175 Issued in AZ
Practice address
901 E Park Dr
Payson, AZ 85541-4442
Phone
(928) 970-1027
NPI assigned
Apr 6, 2018
Last updated
Mar 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-17175 AZ Primary

Addresses

Primary practice location

901 E Park Dr
Payson, AZ 85541-4442

Mailing address

901 E Park Dr
Payson, AZ 85541-4442
Phone (928) 970-1027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20250617001020 AZ Practitioner - Mental Health Counselor 8820509813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1845 McCulloch Blvd N
Suite B1
Lake Havasu City, AZ 86403-6774
Phone (928) 453-2661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-17175AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Behavioral Health Services, Inc. CurrentSince Apr 5, 2025 Accepting new patients
Southwest Behavioral Health Services Inc CurrentSince Apr 5, 2025 Accepting new patients

Locations

1845 McCulloch Blvd N
Ste B1
Lake Havasu City, AZ 86403
Phone (928) 453-2661

404 W Aero Dr
Payson, AZ 85541
Phone (928) 238-3024

2042 N 35th Ave
Phoenix, AZ 85009
Phone (602) 233-0115

3450 N 3rd St
Phoenix, AZ 85012
Phone (602) 257-9339

7600 E Florentine Rd
Ste 101
Prescott Valley, AZ 86314
Phone (928) 775-7088

7600 E Florentine Rd
Ste 201
Prescott Valley, AZ 86314
Phone (928) 775-7088

Organizations & group practices 2

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": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1689171654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E PARK DR",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414442",
            "telephone_number": "928-970-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E PARK DR",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414442",
            "telephone_number": "928-970-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "LORI",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-17175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

Verify at the official NPI Registry.