Healthcare Provider Details

I. General information

NPI: 1699059006
Provider Name (Legal Business Name): SHARLA DENTON BHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4250 E FLORIAN AVE BLDG 1
MESA AZ
85206-2797
US

IV. Provider business mailing address

924 N COUNTRY CLUB DR
MESA AZ
85201-4108
US

V. Phone/Fax

Practice location:
  • Phone: 480-969-3800
  • Fax: 480-222-3221
Mailing address:
  • Phone: 480-969-3800
  • Fax: 480-222-3221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-13722
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC 13722
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: