Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Shanetta Nicholson, LCSW-A

Individual provider Clinical Social Worker · NPI 1558180109

Kimberly Shanetta Nicholson, LCSW-A is a Clinical Social Worker in Goldsboro, North Carolina. Practices as a sole proprietor. Licensed in North Carolina.

Licensed in
NC
In the registry since
2024
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Practice location Address checks out

1503 Wayne Memorial Dr Ste E
Goldsboro, NC 27534-2203
Phone: (919) 587-0001
Fax: (919) 587-0007
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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 · Licence P020106 (NC)

Record details

NPI number1558180109
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW-A
Sole proprietorYes
NPI enumeratedOctober 9, 2024
Last updated in NPPESOctober 9, 2024
Certification dateOctober 9, 2024

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