Provider Demographics
NPI:1073328514
Name:LAFOND, KIMANI (MHC-LP)
Entity type:Individual
Prefix:
First Name:KIMANI
Middle Name:
Last Name:LAFOND
Suffix:
Gender:M
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BLEECKER PL BSMT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12202-1701
Mailing Address - Country:US
Mailing Address - Phone:917-702-9048
Mailing Address - Fax:
Practice Address - Street 1:6 WELLNESS WAY STE 112
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2142
Practice Address - Country:US
Practice Address - Phone:518-881-1109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health