Healthcare Provider Details

I. General information

NPI: 1952814527
Provider Name (Legal Business Name): JENNIFER KATHLEEN HORA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 NASH ST NE
WILSON NC
27893-3045
US

IV. Provider business mailing address

4113 GRAND MANOR CT APT 206
RALEIGH NC
27612-7822
US

V. Phone/Fax

Practice location:
  • Phone: 252-291-2200
  • Fax:
Mailing address:
  • Phone: 631-332-8423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC015315
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: