| Devon Davasher, Lcsw Pllc | |
|
701 South Street Suite 100 Mountain Home AR 72653 | |
| (501) 291-0420 | |
| (866) 728-9492 |
| Full Name | Devon Davasher, Lcsw Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 701 South Street, Mountain Home, Arkansas |
| Authorized Official Name and Position | Devon Brandon Davasher (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 5012910420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Devon Davasher, Lcsw Pllc 6834 Cantrell Rd # 2267 Little Rock AR 72207-4135 Ph: (501) 291-0420 | Devon Davasher, Lcsw Pllc 701 South Street Suite 100 Mountain Home AR 72653 Ph: (501) 291-0420 |
| NPI Number | 1326738444 |
|---|---|
| Provider Enumeration Date | 05/11/2023 |
| Last Update Date | 05/11/2023 |
| Certification Date | 05/03/2023 |
| Medicare PECOS PAC ID | 2264899517 |
|---|---|
| Medicare Enrollment ID | O20230601002119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326738444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Devon Davasher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568895795 PECOS PAC ID: 3870960982 Enrollment ID: I20230601002278 |
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