Provider Demographics
NPI:1700574043
Name:WARBURTON, DENTON (EDS, NCSP)
Entity Type:Individual
Prefix:
First Name:DENTON
Middle Name:
Last Name:WARBURTON
Suffix:
Gender:M
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BISHOP DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2275
Mailing Address - Country:US
Mailing Address - Phone:614-664-3003
Mailing Address - Fax:
Practice Address - Street 1:15 BISHOP DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2275
Practice Address - Country:US
Practice Address - Phone:614-664-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.00708103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool