Provider Demographics
NPI:1447507975
Name:FRANCIS, KENIESHA PATRICE (LMHC)
Entity type:Individual
Prefix:MS
First Name:KENIESHA
Middle Name:PATRICE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 LEE RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2115
Mailing Address - Country:US
Mailing Address - Phone:407-622-6121
Mailing Address - Fax:
Practice Address - Street 1:1850 LEE RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2115
Practice Address - Country:US
Practice Address - Phone:407-622-6121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9769101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH9769OtherPROFESSIONAL LICENSE NUMBER