Provider Demographics
NPI:1366128308
Name:KEISLING, ALANNAH DANIELLE (LMHC)
Entity type:Individual
Prefix:
First Name:ALANNAH
Middle Name:DANIELLE
Last Name:KEISLING
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 1:4951 EASTWOOD GREENS ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-3739
Mailing Address - Country:US
Mailing Address - Phone:941-270-1250
Mailing Address - Fax:
Practice Address - Street 1:12811 KENWOOD LN STE 213
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5648
Practice Address - Country:US
Practice Address - Phone:239-537-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health