Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shelby Kailin Grandolfo

Individual provider Clinical Social Worker · NPI 1770221020

Shelby Kailin Grandolfo is a Clinical Social Worker in Southern Pines, North Carolina. Qualified in 2022, 4 years ago. Practices as a sole proprietor. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2022
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Practice location Address checks out

101 Bradford Village Ct
Southern Pines, NC 28387-5451
Phone: (910) 684-8750
Fax: (910) 725-0536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X (NC)

Record details

NPI number1770221020
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 26, 2022
Last updated in NPPESMay 26, 2022
Certification dateMay 26, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Southern Pines