Shelley Lynn Gilmore, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002621 Issued in NC

Practice address

8404 Six Forks Rd Ste 102
Raleigh, NC 27615-3073

Phone

(919) 412-4581

NPI assigned

Jan 23, 2013

Last updated

Oct 5, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 15, 2026 through Jan 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Evergreen Behavioral Management Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Whiteville, NC
  • NPI 1790860971

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1144568395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8404 SIX FORKS RD STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153073",
            "telephone_number": "919-412-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8404 SIX FORKS RD STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153073",
            "telephone_number": "919-412-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "SHELLEY",
        "middle_name": "LYNN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-23",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Gilliam-Copas
• Abigail Grace Gillis, LCSWA
• Katherine Anne Gillis, PA-C
• Alesia Perkins Gilmore, MS, LCMHC, LPC
• Katherine Ann Gilmore, PNP-PC
• Shivas Gilotra, FNP-C
• Christine May Gilsdorf, MA, LAT, ATC
• Melissa Cathleen Ginesi, AUDIOLOGIST
• Meridith Colleen Ginesi, M.D.
• Ginie Home Care Services Inc (Home Care Services Inc)

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.