Provider Demographics
NPI:1538551676
Name:KANIPE, DONNA M (LMFTA, LPCA)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:KANIPE
Suffix:
Gender:F
Credentials:LMFTA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 CARMEL EXECUTIVE PARK DR STE 210
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-0406
Mailing Address - Country:US
Mailing Address - Phone:704-752-8414
Mailing Address - Fax:704-544-1109
Practice Address - Street 1:7401 CARMEL EXECUTIVE PARK DR STE 210
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-0406
Practice Address - Country:US
Practice Address - Phone:704-752-8414
Practice Address - Fax:704-544-1109
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11486101YP2500X
NC10027A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional