Davenport, Montgomery S

Davenport, Montgomery S is an individual health care provider with primary practice located at 3132 Jefferson St , San Diego CA 92110-4421. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is his primary health care specialty. Davenport, Montgomery S can be contacted via phone (619) 683-3100.

Contact Information

Primary practice address
3132 Jefferson St San Diego CA 92110-4421
Phone: (619) 683-3100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 6401011388 Michigan
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1194085282
LBN Legal business name Davenport, Montgomery S
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2012
Last updated Jul 8th, 2015 - about 11 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.

Request for update

Popular Providers