Provider Demographics
NPI:1255945085
Name:HOPKINS, KENISHA HARRIS (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KENISHA
Middle Name:HARRIS
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6324 FAIRVIEW RD STE 460
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3374
Practice Address - Country:US
Practice Address - Phone:980-302-8611
Practice Address - Fax:980-302-8624
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP014933104100000X
NCC0157361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker