Provider Demographics
NPI:1326594425
Name:DENTON, ELISSA LYNN (MSW, CSWA)
Entity Type:Individual
Prefix:
First Name:ELISSA
Middle Name:LYNN
Last Name:DENTON
Suffix:
Gender:F
Credentials:MSW, CSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 E MAIN ST STE 9
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1827
Mailing Address - Country:US
Mailing Address - Phone:802-535-7485
Mailing Address - Fax:
Practice Address - Street 1:295 E MAIN ST STE 9
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1827
Practice Address - Country:US
Practice Address - Phone:541-247-0789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health