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Individual
KIMBERLY E ELLIS
Active
Individual
KIMBERLY E ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C011215
NC
1041C0700X
Clinical Social Worker
Primary
P009331
NC
Other
Enumeration date
11/05/2015
Last updated
04/21/2026
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