Basic Information
Provider Information
NPI: 1720111735
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KEENER
FirstName: HARRY
MiddleName: JONES
NamePrefix: DR.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 JEFFERSON ST.
Address2: STE. 2C
City: LYNCHBURG
State: VA
PostalCode: 24504
CountryCode: US
TelephoneNumber: 6173790496
FaxNumber: 6178070958
Practice Location
Address1: 5516 FALMOUTH ST.
Address2: STE. 305
City: RICHMOND
State: VA
PostalCode: 23230
CountryCode: US
TelephoneNumber: 8045540356
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/13/2007
LastUpdateDate: 03/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X0701004099VAN Behavioral Health & Social Service ProvidersCounselorProfessional
101YP2500X0701004090VAY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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