Individual provider · Type 1 NPI

Shaverence Lawanda Outlaw, LRT/CTRS

Clinical Social Worker · Kernersville, NC

NPI number 1194356170 Active

Practice location

1695 Kernersville Medical Pkwy
Kernersville, NC 27284-7159

Call (336) 515-5000 Map

Specialties and licenses

TaxonomyCodeLicense
Recreation Therapist 225800000X3879 (NC)
Clinical Social Worker Primary 1041C0700XP023427 (NC)

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 1194356170

Shaverence Lawanda Outlaw, LRT/CTRS's National Provider Identifier is 1194356170, issued on Jan 29, 2020. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Kernersville, NC. The record was last updated on Jun 17, 2026.