Provider Demographics
NPI:1932819281
Name:BRASWELL, KENISHA FLORENCE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KENISHA
Middle Name:FLORENCE
Last Name:BRASWELL
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 1:113 SILVER MAPLE BND
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-9533
Mailing Address - Country:US
Mailing Address - Phone:407-990-2743
Mailing Address - Fax:
Practice Address - Street 1:111 JEWEL DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2715
Practice Address - Country:US
Practice Address - Phone:863-330-0535
Practice Address - Fax:863-877-4682
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical