Provider Demographics
NPI:1285999474
Name:SANDO, KEISHA JEANNINE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KEISHA
Middle Name:JEANNINE
Last Name:SANDO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 SARATOGA AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-3100
Mailing Address - Country:US
Mailing Address - Phone:718-869-1054
Mailing Address - Fax:
Practice Address - Street 1:249 SARATOGA AVE
Practice Address - Street 2:APT 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3100
Practice Address - Country:US
Practice Address - Phone:718-869-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-12
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004410101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health