Kim Ellen, M.A., L.P.C.
NPI 1205025079ActiveIndividual· Counselor· Wilmington, NC
Counselor (M.A., L.P.C.) in Wilmington, North Carolina, licensed in MI and NC, with an NPI issued in October 2007. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1205025079 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.A., L.P.C. |
| Sole proprietor | No |
| NPI issued | Oct 17, 2007 |
| Last updated in NPPES | Dec 16, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor Primary | 101Y00000X | 6401009255 | MI |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 7567 | NC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (NC) |
|---|
Education and affiliations
| Graduation year | 2004 |
|---|---|
| Medicare specialty | Mental Health Counselor |
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