Individual provider · Type 1 NPI

Kenneth Earl Rudolph

Clinical Social Worker · Lynchburg, VA

NPI number 1720564917 Active

Practice location

1600 Lakeside Dr
Lynchburg, VA 24501-3116

Call (434) 363-7219 Map

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X62252 (TX)
Clinical Social Worker 1041C0700X0904018643 (VA)

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 1720564917

Kenneth Earl Rudolph's National Provider Identifier is 1720564917, issued on Jul 11, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Lynchburg, VA. The record was last updated on Mar 16, 2026.