MEDICARE: MCKENZI ROSE HOPKINS LCSWA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	P022470	NC

General Provider Information

NPI Number	:	1114802220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MCKENZI ROSE HOPKINS LCSWA

Provider Business Mailing Address
First Line	:	31A VILLAGE POND LN
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-5080
Country	:	US
Telephone Number	:	910-233-5339
Fax Number	:

Provider Business Practice Location Address
First Line	:	31A VILLAGE POND LN
Second Line	:
City	:	HAMPSTEAD
State	:	NC
Zip	:	28443-5080
Country	:	US
Telephone Number	:	910-233-5339
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	04/17/2026

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