Provider Demographics
NPI:1912610288
Name:BLANCO, KENCY ESPERANZA (RMHCI)
Entity Type:Individual
Prefix:
First Name:KENCY
Middle Name:ESPERANZA
Last Name:BLANCO
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5548 PURDY LN
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-7102
Mailing Address - Country:US
Mailing Address - Phone:772-332-9767
Mailing Address - Fax:
Practice Address - Street 1:15200 S JOG RD STE 303
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1249
Practice Address - Country:US
Practice Address - Phone:561-503-3059
Practice Address - Fax:561-634-2776
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22227101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health