Provider Demographics
NPI:1902489206
Name:STERLING, KESHA MAHALIAH
Entity type:Individual
Prefix:
First Name:KESHA
Middle Name:MAHALIAH
Last Name:STERLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 DUVAL STATION RD APT 107-163
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-0800
Mailing Address - Country:US
Mailing Address - Phone:904-776-5505
Mailing Address - Fax:
Practice Address - Street 1:731 DUVAL STATION RD APT 107-163
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-0800
Practice Address - Country:US
Practice Address - Phone:904-776-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22863101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health