Individual provider · Type 1 NPI
Kendall Basore, MSW, LCSW
Clinical Social Worker · Bloomington, IN
Practice location
445 S. Landmark Ave.
Bloomington, IN 47403
Fax (812) 353-3451
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker | 1041C0700X | 34006602A (IN) |
| Clinical Social Worker Primary | 1041C0700X | 6801100387 (MI) |
| Social Worker | 104100000X | 6801100387 (MI) |
Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…
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About NPI 1104170232
Kendall Basore, MSW, LCSW's National Provider Identifier is 1104170232, issued on Oct 26, 2012. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Bloomington, IN. The record was last updated on Dec 16, 2020.