Provider Demographics
NPI:1720874431
Name:CHEREPNINA, KSENIYA
Entity type:Individual
Prefix:
First Name:KSENIYA
Middle Name:
Last Name:CHEREPNINA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 NAPLES DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1728
Mailing Address - Country:US
Mailing Address - Phone:407-435-2478
Mailing Address - Fax:
Practice Address - Street 1:5449 S SEMORAN BLVD STE 20
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-1778
Practice Address - Country:US
Practice Address - Phone:407-734-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty