Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mikenzie McKimmie, LCSWA

Individual provider Clinical Social Worker · NPI 1972218444

Mikenzie McKimmie, LCSWA is a Clinical Social Worker in Fayetteville, North Carolina. Qualified in 2020, 6 years ago. Practices as a sole proprietor. Licensed in North Carolina.

Years since qualifying
6
Licensed in
NC
In the registry since
2023
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Practice location Address checks out

2935 Breezewood Ave Ste 103
Fayetteville, NC 28303-5498
Phone: (910) 491-1758
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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 P018601 (NC)

Record details

NPI number1972218444
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSWA
Sole proprietorYes
NPI enumeratedJanuary 19, 2023
Last updated in NPPESJanuary 19, 2023
Certification dateJanuary 19, 2023

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Fayetteville