IndividualActive
Kenneth Davis, SAC
NPI 1124384359 · Addiction (Substance Use Disorder) Counselor · Bentonville, AR
Provider details
- NPI number
- 1124384359
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- SAC
- Sex
- Male
- Sole proprietor
- No
- License
- 15651131 (WI)
Practice location
1002 Se C St
Bentonville, AR 72712-6327
Phone: (479) 271-2120
Fax: (479) 271-2219
Mailing address
1002 Se C St
Bentonville, AR 72712-6327
Registry dates
- Enumerated
- 2012-04-02
- Last updated
- 2013-11-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.