Charles R Davenport Psyd LLC
NPI 1063797504ActiveOrganization· Psychologist, Clinical· Sarasota, FL
Psychologist, Clinical in Sarasota, Florida, registered in NPPES in October 2011. The authorized official on file is Charles Robert Davenport, PSY.D., Managing Member.
Overview
| NPI | 1063797504 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 16, 2011 |
| Last updated in NPPES | Jun 10, 2021 |
| Certified by provider | Jun 10, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | PY7978 | FL |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | PY7978 | FL |
| Psychologist, Family | 103TF0000X | PY7978 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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