MEDICARE: DENESHA ALEXANDER

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
2	101YP2500X	Professional Counselor	89010	TX

General Provider Information

NPI Number	:	1114647500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENESHA ALEXANDER

Provider Business Mailing Address
First Line	:	1215 MALL DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 MALL DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4737
Country	:	US
Telephone Number	:	804-594-3690
Fax Number	:

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

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	02/23/2023

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Directions to “ DENESHA ALEXANDER ” Practice Location

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