Provider Demographics
NPI:1003576141
Name:HANEBUTH, KERI LYN (MA, LPCC)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:LYN
Last Name:HANEBUTH
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:LYN
Other - Last Name:DUNNAWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9789 GATESBURY CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8885
Mailing Address - Country:US
Mailing Address - Phone:720-614-6258
Mailing Address - Fax:
Practice Address - Street 1:2305 E ARAPAHOE RD STE 240
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-1565
Practice Address - Country:US
Practice Address - Phone:720-614-6258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0021706101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health