Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kenneth Wayne Davis, SAC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1124384359

Mr. Kenneth Wayne Davis, SAC is an Addiction (Substance Use Disorder) Counselor in Bentonville, Arkansas. Licensed in Wisconsin. Registered with an NPI since 2012.

Licensed in
WI
In the registry since
2012

Practice location Address checks out

1002 SE C St
Bentonville, AR 72712-6327
Phone: (479) 271-2120
Fax: (479) 271-2219
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 15651131 (WI)

Record details

NPI number1124384359
Entity typeIndividual (Type 1)
GenderMale
Credentials SAC
Sole proprietorNo
NPI enumeratedApril 2, 2012
Last updated in NPPESNovember 6, 2013
Mailing address1002 Se C St, Bentonville, AR 72712-6327

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