Provider Demographics
NPI:1861716920
Name:SLEETS, KENNETH KWAHN (MSW, QP)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:KWAHN
Last Name:SLEETS
Suffix:
Gender:M
Credentials:MSW, QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 ROYAL ANNE LANE
Mailing Address - Street 2:APT 102
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615
Mailing Address - Country:US
Mailing Address - Phone:919-474-6400
Mailing Address - Fax:919-474-6401
Practice Address - Street 1:100 CAPITOLA DRIVE
Practice Address - Street 2:SUITE 310
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-474-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health