Healthcare Provider Details

I. General information

NPI: 1922868017
Provider Name (Legal Business Name): EMMA DENTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 BROADWAY ST
PADUCAH KY
42001-0713
US

IV. Provider business mailing address

425 BROADWAY ST
PADUCAH KY
42001-0713
US

V. Phone/Fax

Practice location:
  • Phone: 270-442-7121
  • Fax: 270-443-9692
Mailing address:
  • Phone: 270-442-7121
  • Fax: 270-443-9692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: