Provider Demographics
NPI:1851766802
Name:KEENER, ANDREA (PHD, LMHC, MCAP)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:KEENER
Suffix:
Gender:F
Credentials:PHD, LMHC, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13337 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-4713
Mailing Address - Country:US
Mailing Address - Phone:305-613-9197
Mailing Address - Fax:754-755-3453
Practice Address - Street 1:1500 WESTON RD STE 200-28
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3263
Practice Address - Country:US
Practice Address - Phone:954-955-4544
Practice Address - Fax:754-755-3453
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8352101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)