Provider Demographics
NPI:1801141296
Name:KNEPPER, WESLEY (LPC)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:
Last Name:KNEPPER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 FAIRHILL DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3708 MAYFAIR ST
Practice Address - Street 2:SOUTH SQUARE 2
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6226
Practice Address - Country:US
Practice Address - Phone:919-683-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-21
Last Update Date:2012-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health