Healthcare Provider Details

I. General information

NPI: 1902741887
Provider Name (Legal Business Name): LAKISHA A DENT AA,BS,MA,PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAKISHA ANDREA DENT M.A., PSYD

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4611 E CHANDLER BLVD STE 1124132
PHOENIX AZ
85048-0441
US

IV. Provider business mailing address

4611 E CHANDLER BLVD STE 1124132
PHOENIX AZ
85048-0441
US

V. Phone/Fax

Practice location:
  • Phone: 623-213-3773
  • Fax:
Mailing address:
  • Phone: 623-213-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: