Healthcare Provider Details

I. General information

NPI: 1568306728
Provider Name (Legal Business Name): DREW MCKENZIE DENT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1913 S CHURCH ST STE 2
SMITHFIELD VA
23430-1852
US

IV. Provider business mailing address

7546 KELLOS MILL RD
WAKEFIELD VA
23888-2216
US

V. Phone/Fax

Practice location:
  • Phone: 757-758-5106
  • Fax:
Mailing address:
  • Phone: 757-556-4583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701016116
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: