Individual provider

Kim Ellen, M.A., L.P.C.

Counselor Addiction (Substance Use Disorder) Counselor Medicare enrolled

Kim Ellen, M.A., L.P.C. is a Counselor in Wilmington, NC, registered under NPI 1205025079. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 615 SHIPYARD BLVD, Wilmington, NC 28412. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

615 SHIPYARD BLVD, Wilmington, NC 28412 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
6401009255 MI Counselor primary
7567 NC Addiction (Substance Use Disorder)…

Licences are recorded in 2 states: MI, NC. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Mental Health Counselor
PAC ID
5799275129
Enrollment ID
I20251105001613

Medicare enrolment is recorded as approved under the provider type Practitioner - Mental Health Counselor. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

Licensed in 2 states

This provider holds licences in 2 states: Michigan and North Carolina. The practice address on file is in Wilmington, NC, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.

MI Michigan
Licence
6401009255
Specialty
Counselor
Verify with the MI board →
NC North Carolina practice address
Licence
7567
Specialty
Addiction (Substance Use Disorder)…
Verify with the NC board →

Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.

What Counselor covers

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. NUCC Health Care Provider Taxonomy, code 101Y00000X
Behavioral Health & Social Service Providers Counselor

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
101Y00000X Counselor 6401009255 MI primary
101YA0400X Addiction (Substance Use Disorder) Counselor Addiction (Substance Use Disorder) 7567 NC

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1205025079 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateOct 17, 2007
Last updatedDec 16, 2009
StatusActive
Sole proprietorNo
CredentialM.A., L.P.C.
Practice address 615 SHIPYARD BLVD
Wilmington, NC 28412
(910) 343-0145
Mailing address 2563 CROQUET DR UNIT 7
Wilmington, NC 28412
This record was last updated on Dec 16, 2009, roughly 16 years ago. Address and phone details that old are frequently out of date. Verify by phone before travelling to the address shown.

Number check

1205025079 passes the NPI check digit test The final digit 9 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 2 0 5 0 2 5 0 7
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 2 0 5 0 2 1 0 5

Sum = 41 · next multiple of 10 = 50 · check digit = 9 · actual last digit = 9

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1205025079?
NPI 1205025079 is the National Provider Identifier assigned to Kim Ellen, M.A., L.P.C. in Wilmington, NC. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Counselor cover?
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
How do I contact Kim Ellen, M.A., L.P.C.?
The phone number on file with NPPES is (910) 343-0145, last updated Dec 16, 2009. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Kim Ellen, M.A., L.P.C. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1205025079 a valid number?
Yes. 1205025079 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.