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NPI Code Detail

MEDICARE: KIMBERLY S VAN ENK LCSW

MEDICARE: KIMBERLY S VAN ENK LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker144122CA
2101YA0400XAddiction (Substance Use Disorder) Counselor
31041C0700XClinical Social Worker22429-CAR
41041C0700XClinical Social WorkerC017062NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689944142
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY S VAN ENK LCSW
Provider Business Mailing Address
First Line : 3133 QUINLEY PL
Second Line :
City : RALEIGH
State : NC
Zip : 27604-3358
Country : US
Telephone Number : 310-462-8599
Fax Number :
Provider Business Practice Location Address
First Line : 3133 QUINLEY PL
Second Line :
City : RALEIGH
State : NC
Zip : 27604-3358
Country : US
Telephone Number : 760-994-4990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2011
Last Update Date : 03/05/2026

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Directions to “ KIMBERLY S VAN ENK LCSW” Practice Location

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