Davenport Holistic Healing and Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DAVENPORT HOLISTIC HEALING AND WELLNESS LLC

Practice address

5 Burheight GLN
Spencer, NY 14883-9592

Phone

(607) 744-9438

NPI assigned

Nov 18, 2024

Last updated

Nov 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miranda Davenport, LCSWNPI 1548678972

Title

Owner

Phone

(607) 744-9438

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Miranda Lynn Davenport

  • Clinical Social Worker
  • Elmira, NY
  • NPI 1548678972
  Medicare reassignment NPD Authorized official
• Jessica L Krohn, LCSW

  • Clinical Social Worker
  • Binghamton, NY
  • NPI 1760060792
  NPD
• Stefanie Jean Pickens, LCSWR

  • Clinical Social Worker
  • Vestal, NY
  • NPI 1578747523
  NPD
• Susan W. Blue, PH.D.

  • Psychologist
  • Johnson City, NY
  • NPI 1366522195
  NPD (past)
• Bobbie Jo Deuel-Lewis

  • Clinical Social Worker
  • Vestal, NY
  • NPI 1063774792
  NPD (past)
• Jerry David Duvinsky, PHD

  • Clinical Psychologist
  • Johnson City, NY
  • NPI 1265504211
  NPD (past)
• Kara Kenderish, PSY.D.

  • Clinical Psychologist
  • Kirkwood, NY
  • NPI 1457832776
  NPD (past)
• Michael Bruce Lister, PSY.D.

  • Clinical Psychologist
  • Endicott, NY
  • NPI 1215203914
  NPD (past)
• Brittany J Rigoli, LCSW

  • Social Worker
  • Owego, NY
  • NPI 1902144439
  NPD (past)
• Cheryl Lynn Scott-Richard, PSY.D.

  • Clinical Psychologist
  • Endicott, NY
  • NPI 1942499389
  NPD (past)

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1699590307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BURHEIGHT GLN",
            "city": "SPENCER",
            "state": "NY",
            "postal_code": "148839592",
            "telephone_number": "607-744-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BURHEIGHT GLN",
            "city": "SPENCER",
            "state": "NY",
            "postal_code": "148839592",
            "telephone_number": "607-744-9438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVENPORT HOLISTIC HEALING AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "607-744-9438",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alton Lee Annabel D.C.
• Alton L Annabel, D.C.
• Nicholas M Annesi, LAT
• Sarah Bast, RN
• Blue Sky Center for Learning
• Jennifer Rae Farnsworth, LPN
• Pamela Elaine Goodman, RN
• Gail Louise Hall
• Patricia L Harmon, RN
• Babbie J Hart, LPN

• Clinical Social Worker in Spencer, NY
• Providers in Spencer, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.