Individual provider Active NPI

Amy Lynn Ketner, MA, LCMHC

  • Mental Health Counselor
  • Cary, NC
National Provider Identifier
1861781791
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11489 Issued in NC
Practice address
600 New Waverly PL Ste 203
Cary, NC 27518-7404
Phone
(919) 410-7083
NPI assigned
Mar 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 11489 NC Primary

Addresses

Primary practice location

600 New Waverly PL Ste 203
Cary, NC 27518-7404

Mailing address

PO Box 96860
Charlotte, NC 28296-6860
Phone (910) 410-7083

Other identifiers 2

IdentifierTypeStateIssuer
405127MedicaidSC
1861781791MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240118002658 NC Practitioner - Mental Health Counselor 0244682987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Raleigh Durham Medical Group PAGroup PAC ID 2365409588, 80 clinicians

Practice addresses (Care Compare)

600 New Waverly PL
Suite 203
Cary, NC 27518-7404
Phone (919) 859-5650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
RDMG Associates, PA Mental Health Current Accepting new patients
Raleigh Durham Medical Group PA CurrentSince Nov 28, 2024 Accepting new patients
Raleigh Durham Medical Group PA CurrentSince Nov 28, 2024 Accepting new patients

Locations

600 New Waverly Pl
Ste 203
Cary, NC 27518
Phone (919) 410-7083

97 Cornerstone Dr
Cary, NC 27519
Phone (919) 460-0993

10620 Park Rd
Ste 128
Charlotte, NC 28210
Phone (704) 542-6111

7124 US Highway 64 E
Knightdale, NC 27545
Phone (919) 266-6211

7205 Stonehenge Dr
Ste 200
Raleigh, NC 27613
Phone (919) 410-7083

Interoperability endpoints

  • Direct secure messaging: amyketner@rdmgbh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1861781791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96860",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282966860",
            "telephone_number": "910-410-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NEW WAVERLY PL STE 203",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187404",
            "telephone_number": "919-410-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETNER",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "MA, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-31",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "11489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405127",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861781791",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.