MEDICARE: ALICIA DENTON LPC-MHSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6905	TN

General Provider Information

NPI Number	:	1114753126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA DENTON LPC-MHSP

Provider Business Mailing Address
First Line	:	2676 MORNING WOODS DR
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38016-4762
Country	:	US
Telephone Number	:	901-569-6316
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 POPLAR AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4426
Country	:	US
Telephone Number	:	901-650-7127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	04/02/2026

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