Provider Demographics
NPI:1316297336
Name:DUCKENFIELD, DEANA (LMHC, MCAP, LPC)
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:DUCKENFIELD
Suffix:
Gender:F
Credentials:LMHC, MCAP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 HIGH CT
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-5533
Mailing Address - Country:US
Mailing Address - Phone:386-214-0297
Mailing Address - Fax:
Practice Address - Street 1:1336 HIGH CT
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32952-5533
Practice Address - Country:US
Practice Address - Phone:386-214-0297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2023-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13379101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health