Provider Demographics
NPI:1598236911
Name:KING, LAKENDRA DANIELE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAKENDRA
Middle Name:DANIELE
Last Name:KING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 SAND LAKE RESERVE DR APT 1201
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7345
Mailing Address - Country:US
Mailing Address - Phone:786-291-3229
Mailing Address - Fax:
Practice Address - Street 1:740 FLORIDA CENTRAL PKWY STE 2008
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-7653
Practice Address - Country:US
Practice Address - Phone:407-774-2284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-10
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW188091041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker