1. Home
  2. Directory
  3. North Carolina
  4. Raleigh
  5. Social Worker
  6. NPI Profile

MR. KENNETH LOUIS SHORE LCSW
NPI 1871762641
Social Worker - Clinical in Raleigh, NC

Active since February 26, 2008
4112 BLUE RIDGE ROAD, 2ND FLOOR, RALEIGH, NC 27612(919) 573-6520(919) 573-6557 Get Directions Write a Review

NPPES record last updated: February 26, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Kenneth Louis Shore Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. KENNETH LOUIS SHORE LCSW (NPI 1871762641) is an individual clinical provider in Raleigh, North Carolina, licensed in North Carolina (C003006) and active in the NPI registry since February 2008.

NPPES Registry Identity

NPI1871762641
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KENNETH LOUIS SHORECredential: LCSW
Location Address4112 BLUE RIDGE ROAD, 2ND FLOORRaleigh, NC 27612-4652
Mailing Address25 Blackstone Valley Place, Suite 300 Fellowship Health Resources IncLincoln, RI 02865-1163 · (401) 333-3980 · Fax (401) 333-3980
Phone(919) 573-6520
Fax(919) 573-6557
Sole ProprietorNo
Enumeration DateFebruary 26, 2008
✔ NPI 1871762641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NC · C003006
Definition
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.
4112 BLUE RIDGE ROAD, Raleigh, NC 27612
Open in Google Maps ↗

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. DIANA WYDO LCSW
Social Worker (Clinical)
4112 BLUE RIDGE ROAD, 2ND FLOOR
RALEIGH, NC 27612
Wake County (919) 573-6520

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Shore's NPI number?

The NPI number for Kenneth Shore is 1871762641. It was assigned to this individual provider in the NPPES registry on February 26, 2008.

Where is Kenneth Shore located?

Kenneth Shore practices at 4112 Blue Ridge Road 2nd Floor, Raleigh, NC 27612. The listed phone number is (919) 573-6520.

What is Kenneth Shore's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Kenneth Shore was last updated on February 26, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.