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
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701004099 | VA | N |   | Behavioral Health & Social Service Providers | Counselor | Professional | 101YP2500X | 0701004090 | VA | Y |   | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.