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General NPI Number Information
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NPI Number | 1003576141
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Entity Type | Individual
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Provider Name | KERI LYN HANEBUTH MA, LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 2305 E ARAPAHOE RD STE 240
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City | CENTENNIAL
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State | CO
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Zip | 80122-1565
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Country | US
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Telephone | 720-614-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 9789 GATESBURY CIR
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80126-8885
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Country | US
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Telephone | 720-614-6258
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.0021706
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License Number State | CO
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