Provider Demographics
NPI:1144907072
Name:DEASCANIS, KATHRYN (RMHCI)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DEASCANIS
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 1:2612 AMSDEN RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3513
Mailing Address - Country:US
Mailing Address - Phone:407-463-4798
Mailing Address - Fax:
Practice Address - Street 1:220 LOOKOUT PL
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-8440
Practice Address - Country:US
Practice Address - Phone:407-205-7734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH24122101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health