MEDICARE: KERRY HOPSON MSW, LCSW

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	0904008587	VA
2	1041C0700X	Clinical Social Worker	C008923	NC

General Provider Information

NPI Number	:	1417365685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRY HOPSON MSW, LCSW

Provider Business Mailing Address
First Line	:	5917 DEEP SPRING CIR
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-6880
Country	:	US
Telephone Number	:	540-907-3877
Fax Number	:

Provider Business Practice Location Address
First Line	:	2006 S MAIN ST STE 204
Second Line	:
City	:	WAKE FOREST
State	:	NC
Zip	:	27587-9391
Country	:	US
Telephone Number	:	919-575-6103
Fax Number	:	919-575-6817

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

Provider Enumeration Date	:	07/31/2014
Last Update Date	:	01/13/2026

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