MIKENZIE MCKIMMIE LCSWA
NPI 1972218444
Social Worker - Clinical in Fayetteville, NC

Q: What is Mikenzie Mckimmie's NPI number?

The NPI number for Mikenzie Mckimmie is 1972218444. It was assigned to this individual provider in the NPPES registry on January 19, 2023.

Q: What is Mikenzie Mckimmie's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Mikenzie Mckimmie was last updated on January 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since January 19, 2023PECOS Enrolled

2935 BREEZEWOOD AVE STE 103, FAYETTEVILLE, NC 28303(910) 491-1758 Get Directions Write a Review

NPPES record last updated: January 19, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Mikenzie Mckimmie Lcswa NPPES

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

MIKENZIE MCKIMMIE LCSWA (NPI 1972218444) is an individual clinical provider in Fayetteville, North Carolina, licensed in North Carolina (P018601) and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1972218444

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMIKENZIE MCKIMMIECredential: LCSWA

Location Address2935 BREEZEWOOD AVE STE 103Fayetteville, NC 28303-5498

Mailing Address2935 Breezewood Ave Ste 103Fayetteville, NC 28303-5498 · (910) 491-1758

Phone(910) 491-1758

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateJanuary 19, 2023

NPPES CertifiedJanuary 19, 2023

✔ NPI 1972218444 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NC · P018601

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

2935 BREEZEWOOD AVE STE 103, Fayetteville, NC 28303

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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, Cigna Healthcare, Oscar Health Maintenance Organization of Florida and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mikenzie Mckimmie Lcswa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1254837099

PECOS Enrollment IDI20251001001583

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.

Medicare Billing Reassignments

Medicare enrollment records show Mikenzie Mckimmie reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Second Chance Counseling Services, PLLC

Same address

Clinical

2935 BREEZEWOOD AVE STE 103
Fayetteville, NC 28303

Reassigned Medicare billing, North Carolina enrollment
3 clinicians in this Medicare group

NPI 1801308143 (910) 491-1758

Grow Healthcare Group PA

643 mi

Mental Health

66 W FLAGLER ST STE 900
Miami, FL 33130

Reassigned Medicare billing, North Carolina enrollment
712 clinicians in this Medicare group

NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28303 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $54.12 – $165.09

Typical copayment $0.00 (range $13.53 – $41.27)

Most-billed visit code NA

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

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

ANGIE EDWARDS LCSW-A

Social Worker (Clinical)