Individual
DR. KENNARD NEARS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., LPC, NCC
Contact information
Practice address
187 SHENANDOAH DR, RIVERDALE, GA 30274-3247
(919) 395-3622
Mailing address
187 SHENANDOAH DR, RIVERDALE, GA 30274-3247
(919) 395-6222
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5129
NC
101YM0800X
Mental Health Counselor
Primary
005130
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
526553690B
—
GA
05
—
6103009
—
NC
Enumeration date
01/14/2007
Last updated
04/01/2019
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