Provider Demographics
NPI:1477883940
Name:KERNS, RENEE EVANS (LPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:EVANS
Last Name:KERNS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 885
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-0885
Mailing Address - Country:US
Mailing Address - Phone:252-862-4411
Mailing Address - Fax:252-862-4414
Practice Address - Street 1:2000 W NASH STREET
Practice Address - Street 2:SUITE D
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-1724
Practice Address - Country:US
Practice Address - Phone:252-862-4411
Practice Address - Fax:252-862-4414
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health