Davenport, Lera Josie

Davenport, Lera Josie is an sole proprietor health care provider with primary practice located at 6421 Sw 13Th St , Gainesville FL 32608-5419. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Technologists, Technicians & Other Technical Service Providers / Technician, Other. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Davenport, Lera Josie can be contacted via phone (352) 514-5076.

Contact Information

Primary practice address
6421 Sw 13Th St Gainesville FL 32608-5419
Phone: (352) 514-5076
Fax: (352) 373-3950
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW 5130 Florida
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X MA 3599 Florida

Profile Details

NPI number 1891987020
LBN Legal business name Davenport, Lera Josie
Credentials L.M.T, L.C.S.W.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2007
Last updated Aug 12th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891987020 NPPES
Florida Other #C8547 LMT BLUE CROSS/BLUE SHIELD
Florida Other #Z8967 LCSW BLUE CROSS/BLUE SHIELD

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