Provider Demographics
NPI:1932417052
Name:CAPNERHURST, KEANNA L (LCMHC)
Entity Type:Individual
Prefix:MS
First Name:KEANNA
Middle Name:L
Last Name:CAPNERHURST
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HUNDRED OAKS LN
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-4457
Mailing Address - Country:US
Mailing Address - Phone:919-909-1080
Mailing Address - Fax:
Practice Address - Street 1:875 WALNUT ST STE 300
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4215
Practice Address - Country:US
Practice Address - Phone:919-909-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-23
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8257101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional