Provider Demographics
NPI:1346087731
Name:DENNY, LONDEN LAREE
Entity type:Individual
Prefix:
First Name:LONDEN
Middle Name:LAREE
Last Name:DENNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 MARKET ST STE 4
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1426
Mailing Address - Country:US
Mailing Address - Phone:910-777-5575
Mailing Address - Fax:910-777-5273
Practice Address - Street 1:3825 MARKET ST STE 4
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1426
Practice Address - Country:US
Practice Address - Phone:910-777-5575
Practice Address - Fax:910-777-5273
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1300X
NCP0209321041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial Worker