Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Rose, LISW-CP

Individual provider Social Worker · NPI 1598912784

Kimberly Rose, LISW-CP is a Clinical Social Worker in Wilmington, North Carolina. Qualified in 2006, 20 years ago. Practices with Lifesource of North Carolina, a 170-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
20
Licensed in
NC
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone: (910) 742-9243
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 31 College Place, Asheville, NC 28801 — (828) 242-8648

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Social Worker Taxonomy 104100000X · Licence 009570 (NC)

Record details

NPI number1598912784
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW-CP
Sole proprietorNo
NPI enumeratedAugust 19, 2008
Last updated in NPPESNovember 8, 2018

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Lifesource Of North Carolina — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Wilmington