Provider Demographics
NPI:1952764250
Name:DENT, STARLETTE (MS,PCMHT)
Entity Type:Individual
Prefix:MS
First Name:STARLETTE
Middle Name:
Last Name:DENT
Suffix:
Gender:F
Credentials:MS,PCMHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 BROWNING ROAD 520
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-6022
Mailing Address - Country:US
Mailing Address - Phone:662-451-5439
Mailing Address - Fax:
Practice Address - Street 1:2504 BROWNING ROAD 520
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-6022
Practice Address - Country:US
Practice Address - Phone:662-451-5439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPH3190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health