MR. KENNETH LOUIS SHORE (NPI# 1871762641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871762641 |
Entity Type | Individual |
Full Name | MR. KENNETH LOUIS SHORE |
Credential | LCSW |
Practice Address |
4112 Blue Ridge Road 2nd Floor Raleigh NC 27612-4652 |
Mailing Address |
25 Blackstone Valley Place Suite 300 Fellowship Health Resources Inc Lincoln RI 02865-1163 |
Practice Telephone | 9195736520 |
Practice Fax Number | 9195736557 |
Mailing Telephone | 4013333980 |
Mailing Fax Number | 4013333980 |
Enumeration Date | 2008-02-26 |
Last Update Date | 2008-02-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1041C0700X |
Social Worker Specialization: Clinical |
C003006 | NC | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114960606 | Kenneth Alan Shore | Internal Medicine | 5501 Independence Pkwy Ste 110, Plano, TX 75023-5472 | 2006-06-13 |
Street Address |
4112 BLUE RIDGE ROAD 2ND FLOOR |
City | RALEIGH |
State | NC |
Zip Code | 27612-4652 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619146305 | Diana Wydo | Social Worker | 4112 Blue Ridge Road, 2nd Floor, Raleigh, NC 27612-4652 | 2008-02-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538714068 | George J Henderon | Orthotist | 5313 Duraleigh Road, Ste 151, Raleigh, NC 27612 | 2019-08-01 |
1902399223 | Iain Knox Nathaniel Irwin | Marriage & Family Therapist | 7701 Alborz Dr, Raleigh, NC 27612 | 2018-06-12 |
1225525884 | Patterns Behavioral Services North Carolina, Inc | Assistant Behavior Analyst | 3738 National Dr, Ste 110, Raleigh, NC 27612 | 2018-04-19 |
1053820720 | The Art Counseling L.L.C. | Psychologist | 4610 Twisted Oaks Drive Apt 1807, Raleigh, NC 27612 | 2017-09-26 |
1376052431 | Amanda Steed | Speech-Language Pathologist | 5519 Hamstead Crossing, Raleigh, NC 27612 | 2017-09-21 |
1295250991 | Neal H. Patel Dds Pllc | Dentist | 7211 Shellburne Dr, Raleigh, NC 27612 | 2017-08-03 |
1811426109 | Marquita Randolph-breeden | Behavior Technician | 5816 Creedmoor Road, Suite 104, Raleigh, NC 27612 | 2017-06-08 |
1336518554 | Travis Edward Williams | Counselor | 4801 Glenwood Ave., Suite 200, Raleigh, NC 27612 | 2015-09-17 |
1831587476 | Harris Teeter LLC | Pharmacy | 2051 W Millbrook Road, Raleigh, NC 27612 | 2015-01-06 |
1780072975 | Harris Teeter LLC | Pharmacy | 2051 W. Millbrook Road, Raleigh, NC 27612 | 2014-12-23 |
Find all providers in zip 27612 |
Taxonomy Code | 1041C0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Social Worker |
Specialization | Clinical |
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295333516 | Susan Silberman | Social Worker | 8480 Honeycutt Rd Ste 200, Raleigh, NC 27615-2261 | 2020-10-09 |
1427665074 | Arshiya F Siddiqui | Social Worker | 12900 Saxon Way, Raleigh, NC 27613-5753 | 2020-09-28 |
1427661784 | Priscilla Janine James | Social Worker | 913 Haynes St, Raleigh, NC 27604-1463 | 2020-08-26 |
1730791443 | Robin Hotard Roche | Social Worker | 3209 Clandon Park Dr, Raleigh, NC 27613-8839 | 2020-08-24 |
1124639786 | Richetta White | Social Worker | 2921 Berkeley Springs Pl, Raleigh, NC 27616-6645 | 2020-08-16 |
1356950349 | Rachel Elizabeth Zarcone | Social Worker | 702 Van Buren Rd, Raleigh, NC 27604-2368 | 2020-07-27 |
1881202794 | Nikki Atkins | Social Worker | 3125 Poplarwood Ct Ste 211, Raleigh, NC 27604-6445 | 2020-07-16 |
1770100547 | Flourish Mental Health Pllc | Social Worker | 8307 Six Forks Rd Ste 201, Raleigh, NC 27615-3768 | 2020-06-28 |
1235756057 | Amy Boiselle Fitzgerald | Social Worker | 524 S Boylan Ave, Raleigh, NC 27603-2130 | 2020-06-27 |
1639798200 | Tatiana Alicia Hinton | Social Worker | 3117 Poplarwood Ct Ste 350, Raleigh, NC 27604-6446 | 2020-04-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.