Individual provider · Type 1 NPI

Kenneth Louis Shore, LCSW

Clinical Social Worker · Raleigh, NC

NPI number 1871762641 Active

Practice location

4112 Blue Ridge Road, 2nd Floor
Raleigh, NC 27612-4652

Call (919) 573-6520 Map

Fax (919) 573-6557

Mailing address

25 Blackstone Valley Place, Suite 300 Fellowship Health Resources Inc
Lincoln, RI 02865-1163

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XC003006 (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 1871762641

Kenneth Louis Shore, LCSW's National Provider Identifier is 1871762641, issued on Feb 26, 2008. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Raleigh, NC. The record was last updated on Feb 26, 2008.