Provider Demographics
NPI:1073081295
Name:DUKES, KESHIA (LPC)
Entity Type:Individual
Prefix:
First Name:KESHIA
Middle Name:
Last Name:DUKES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 LAKEVIEW DR STE C
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-4310
Mailing Address - Country:US
Mailing Address - Phone:662-809-2735
Mailing Address - Fax:
Practice Address - Street 1:639 LAKEVIEW DR STE C
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-4310
Practice Address - Country:US
Practice Address - Phone:662-809-2735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health