Active NPI
Mary Angela Davenport, L.M.F.T.
- Marriage & Family Therapist
- Hendersonville, TN
National Provider Identifier
1861791626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 808
- Practice address
- 105 Music Village Blvd
Hendersonville, TN 37075-2714 - Phone
- (615) 824-3772
- Fax
- (615) 447-1065
- NPI assigned
- Mar 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 808 | TN | Primary |
Addresses
Primary practice location
105 Music Village Blvd
Hendersonville, TN 37075-2714
Mailing address
105 Music Village Blvd
Hendersonville, TN 37075-2714
Phone (615) 824-3772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 808 | TN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300492800000",
"number": "1861791626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 MUSIC VILLAGE BLVD",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370752714",
"telephone_number": "615-824-3772",
"fax_number": "615-447-1065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 MUSIC VILLAGE BLVD",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370752714",
"telephone_number": "615-824-3772",
"fax_number": "615-447-1065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVENPORT",
"first_name": "MARY",
"middle_name": "ANGELA",
"credential": "L.M.F.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-19",
"last_updated": "2011-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.