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

MS. Kim Ellen, MA, LPC

Individual provider Counselor · NPI 1205025079

MS. Kim Ellen, MA, LPC is a Mental Health Counselor in Wilmington, North Carolina. Qualified in 2004, 22 years ago. Accepts Medicare assignment. Licensed in Michigan and North Carolina.

Years since qualifying
22
Licensed in
MI, NC
In the registry since
2007
Specialties on file
2
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone: (910) 343-0145
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence 6401009255 (MI)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 7567 (NC)

Record details

NPI number1205025079
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , LPC
Sole proprietorNo
NPI enumeratedOctober 17, 2007
Last updated in NPPESDecember 16, 2009

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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