Provider Demographics
NPI:1972029270
Name:O'KEEFE, MICHELLE (MS, RMHCI)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:MYSLIWIEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1597 WILD FOX DR
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5298
Mailing Address - Country:US
Mailing Address - Phone:407-256-4505
Mailing Address - Fax:
Practice Address - Street 1:2479 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:407-657-6692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health