1. Home
  2. Directory
  3. Minnesota
  4. Plymouth
  5. Counselor
  6. NPI Profile

MRS. CANDIDA AMBER DAVENPORT LAC, LADC
NPI 1932138765
Counselor - Addiction (Substance Use Disorder) in Plymouth, MN

Active since July 02, 2006
115 FORESTVIEW LN N, PLYMOUTH, MN 55441(763) 546-8008(763) 546-7674 Get Directions Write a Review

NPPES record last updated: June 24, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mrs. Candida Amber Davenport Lac, Ladc NPPES

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

MRS. CANDIDA AMBER DAVENPORT LAC, LADC (NPI 1932138765) is an individual addiction (substance use disorder) provider in Plymouth, Minnesota, licensed in Minnesota (303356) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1932138765
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMRS. CANDIDA AMBER DAVENPORTCredential: LAC, LADC
Location Address115 FORESTVIEW LN NPlymouth, MN 55441-5910
Mailing Address115 Forestview Ln NPlymouth, MN 55441-5910 · (763) 546-8008 · Fax (763) 546-7674
Phone(763) 546-8008
Fax(763) 546-7674
Sole ProprietorNo
Enumeration DateJuly 2, 2006
Last NPPES UpdateJune 24, 2013
✔ NPI 1932138765 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
Licenses✔ Licensed in MN · 303356✔ Licensed in ND · 1492
115 FORESTVIEW LN N, Plymouth, MN 55441
Open in Google Maps ↗

Other Identifiers 3

Other022581ND · Bcbs Nd Provider Number
Other92OS7KIMN · Bcbs Mn Provider Number
Medicaid054519ND

Other Providers at the Same Location NPPES 2

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

EMILY CROSS MA, LADC
Counselor (Addiction (Substance Use Disorder))
115 FORESTVIEW LN N
PLYMOUTH, MN 55441
Hennepin County (763) 546-8008
MATTHEW PATRICK MCCAULEY LADC
Counselor (Addiction (Substance Use Disorder))
115 FORESTVIEW LN N
PLYMOUTH, MN 55441
Hennepin County (763) 546-8008

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 Candida Davenport's NPI number?

The NPI number for Candida Davenport is 1932138765. It was assigned to this individual provider in the NPPES registry on July 2, 2006.

Where is Candida Davenport located?

Candida Davenport practices at 115 Forestview Ln N, Plymouth, MN 55441. The listed phone number is (763) 546-8008.

What is Candida Davenport'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 Candida Davenport was last updated on June 24, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.