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MR. KENNETH WAYNE DAVIS SAC
NPI 1124384359
Counselor - Addiction (Substance Use Disorder) in Bentonville, AR

Active since April 02, 2012
1002 SE C ST, BENTONVILLE, AR 72712(479) 271-2120(479) 271-2219 Get Directions Write a Review

NPPES record last updated: November 6, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kenneth Wayne Davis Sac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KENNETH WAYNE DAVIS SAC (NPI 1124384359) is an individual addiction (substance use disorder) provider in Bentonville, Arkansas, licensed in Wisconsin (15651131) and active in the NPI registry since April 2012.

NPPES Registry Identity

NPI1124384359
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. KENNETH WAYNE DAVISCredential: SAC
Location Address1002 SE C STBentonville, AR 72712-6327
Mailing Address1002 Se C StBentonville, AR 72712-6327 · (479) 271-2120 · Fax (479) 271-2219
Phone(479) 271-2120
Fax(479) 271-2219
Sole ProprietorNo
Enumeration DateApril 2, 2012
Last NPPES UpdateNovember 6, 2013
✔ NPI 1124384359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in WI · 15651131
1002 SE C ST, Bentonville, AR 72712
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Other Names 1

Professional Name (2)Mr. Kenneth W Davis Sac

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE BELK MS
Counselor (Mental Health)
1002 SE C ST
BENTONVILLE, AR 72712
Benton County (479) 271-2120
MANDA J DAVIS LADAC,BCC
Counselor (Addiction (Substance Use Disorder))
1002 SE C ST
BENTONVILLE, AR 72712
Benton County (479) 271-2120
MATTHEW WALKER LONG MA
Counselor (Addiction (Substance Use Disorder))
1002 SE C ST
BENTONVILLE, AR 72712
Benton County (479) 271-2120
ELEMENTAL COUNSELING
Clinic/Center (Mental Health (Including Community Mental Health Center))
1002 SE C ST
BENTONVILLE, AR 72712
Benton County (479) 925-4444
SWEET EMOTIONS COUNSELING LLC
Community/Behavioral Health
1002 SE C ST
BENTONVILLE, AR 72712
Benton County (479) 271-2120

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Davis's NPI number?

The NPI number for Kenneth Davis is 1124384359. It was assigned to this individual provider in the NPPES registry on April 2, 2012. The provider is also known as Mr. Kenneth W Davis Sac.

Where is Kenneth Davis located?

Kenneth Davis practices at 1002 SE C St, Bentonville, AR 72712. The listed phone number is (479) 271-2120.

What is Kenneth Davis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kenneth Davis was last updated on November 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.