Jennifer Kristen Davenport, MS, LCADC, CCS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37LC00339600 Issued in NJ

Practice address

1930 Marlton Pike E Ste E27
Cherry Hill, NJ 08003-4101

Phone

(732) 231-5180

Fax

(732) 231-5189

NPI assigned

Nov 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1760148530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E STE E27",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034101",
            "telephone_number": "732-231-5180",
            "fax_number": "732-231-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 MARLTON PIKE E STE E27",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034101",
            "telephone_number": "732-231-5180",
            "fax_number": "732-231-5189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVENPORT",
        "first_name": "JENNIFER",
        "middle_name": "KRISTEN",
        "name_prefix": "Mrs.",
        "credential": "MS, LCADC, CCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00339600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shakema Terrell Dashiell, MS, MA, LAPC
• Justin Datorre, PT, DPT
• Sarah Dattilo, BCBA
• Sonore Daudin
• Ma Ronella Muchada Daulo, RPT
• Richard Davenport
• David a Mellul DPM
• David Orthopedic
• Destiny David
• Henry Edward David, DO

• Addiction (Substance Use Disorder) Counselor in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Addiction (Substance Use Disorder) Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.