Individual
ERIC DAVENPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 524-4953
(208) 524-7335
Mailing address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 524-4953
(208) 524-7335
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-34320
ID
104100000X
Social Worker
Primary
LMSW-34320
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346368198
—
ID
Enumeration date
12/09/2014
Last updated
02/17/2026
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