Individual
AMY LYNN KETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHC
Contact information
Practice address
600 NEW WAVERLY PL STE 203, CARY, NC 27518-7404
(919) 410-7083
Mailing address
PO BOX 96860, CHARLOTTE, NC 28296-6860
(910) 410-7083
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11489
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861781791
—
NC
05
—
405127
—
SC
Enumeration date
03/31/2011
Last updated
06/04/2025
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