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MS. KIM ELLEN M.A., L.P.C.
NPI 1205025079
Counselor in Wilmington, NC

Active since October 17, 2007PECOS EnrolledAccepts Medicare Assignment
615 SHIPYARD BLVD, WILMINGTON, NC 28412(910) 343-0145 Get Directions Write a Review

NPPES record last updated: December 16, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Kim Ellen M.a., L.p.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KIM ELLEN M.A., L.P.C. (NPI 1205025079) is an individual counselor in Wilmington, North Carolina, licensed in Michigan (6401009255) and active in the NPI registry since October 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2004).

NPPES Registry Identity

NPI1205025079
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameMS. KIM ELLENCredential: M.A., L.P.C.
Location Address615 SHIPYARD BLVDWilmington, NC 28412-6431
Mailing Address2563 Croquet Dr Unit 7Wilmington, NC 28412-5179 · (910) 338-8251
Phone(910) 343-0145
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateOctober 17, 2007
Last NPPES UpdateDecember 16, 2009
✔ NPI 1205025079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
License✔ Licensed in MI · 6401009255
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 7567 (NC)
615 SHIPYARD BLVD, Wilmington, NC 28412
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Kim Ellen M.a., L.p.c. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5799275129
PECOS Enrollment IDI20251105001613
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COASTAL HORIZONS CENTER, INC.
Psychologist (Prescribing (Medical))
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 790-0187
MISS MARY FLORENCE WOOD LCSWA
Social Worker (Clinical)
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 617-9647
MRS. ISABELLA LECCI PATE LCSWA
Social Worker (Clinical)
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 931-4147
WHITNEY SHANTE JONES
Social Worker (Clinical)
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 343-0145
TERRANCE WILLIAMS LCSW
Social Worker (Clinical)
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 343-0145
DANIELLE MARGARET ROBBINS LCSW-A
Social Worker (Clinical)
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 399-3755
BRITTNEY PROCTOR LCSW
Social Worker (Clinical)
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 202-3155
TAMMY MICHELE JOHNSON-MCKOY LCSWA
Social Worker (Clinical)
615 SHIPYARD BLVD
WILMINGTON, NC 28412
New Hanover County (910) 343-0145

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Ellen's NPI number?

The NPI number for Kim Ellen is 1205025079. It was assigned to this individual provider in the NPPES registry on October 17, 2007.

Where is Kim Ellen located?

Kim Ellen practices at 615 Shipyard Blvd, Wilmington, NC 28412. The listed phone number is (910) 343-0145.

What is Kim Ellen's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Kim Ellen enrolled in Medicare?

Yes. Kim Ellen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kim Ellen accept?

Health plans from Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc and UnitedHealthcare list Kim Ellen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kim Ellen was last updated on December 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.