MEDICARE: TENIKKA DENARD

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	2658	NH
2	101YM0800X	Mental Health Counselor	11965	NC

General Provider Information

NPI Number	:	1134547904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TENIKKA DENARD

Provider Business Mailing Address
First Line	:	1235 EAST BLVD STE E-1752
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5870
Country	:	US
Telephone Number	:	318-779-4778
Fax Number	:

Provider Business Practice Location Address
First Line	:	1235 EAST BLVD STE E-1752
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28203-5870
Country	:	US
Telephone Number	:	318-779-4778
Fax Number	:

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

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	11/09/2023

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Directions to “ TENIKKA DENARD ” Practice Location

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