Provider Demographics
NPI:1811480247
Name:BARTHELEMY, KEESHA ALEXANDRA (LMHC, CASAC-2)
Entity type:Individual
Prefix:
First Name:KEESHA
Middle Name:ALEXANDRA
Last Name:BARTHELEMY
Suffix:
Gender:F
Credentials:LMHC, CASAC-2
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 DREXEL LN APT 1204
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-5223
Mailing Address - Country:US
Mailing Address - Phone:646-552-0883
Mailing Address - Fax:
Practice Address - Street 1:6011 DREXEL LN APT 1204
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-5223
Practice Address - Country:US
Practice Address - Phone:646-552-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health