Active NPI
Kimberlee Lynne Miller-Urban, MA. EDS
- Clinical Psychologist
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2612
- Practice address
- 2002 Eastwood Rd
Suite 305
Wilmington, NC 28403-7218 - Phone
- (910) 509-0588
- Fax
- (910) 509-0586
- NPI assigned
- Jan 4, 2007
- Last updated
- Sep 8, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2612 | NC | |
| Clinical Psychologist | 103TC0700X | 2612 | NC | Primary |
| School Psychologist | 103TS0200X | 2612 | NC |
Addresses
Primary practice location
2002 Eastwood Rd
Suite 305
Wilmington, NC 28403-7218
Mailing address
100 N Gadwall CT
Hampstead, NC 28443-7159
Phone (910) 538-5334
Other practice location 1
3317 Masonboro Loop Rd Unit 160
Wilmington, NC 28409-2970
Phone (910) 538-5334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2612 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Psychologial Services, PA | Current | Accepting new patients | |
| Sound Psychologial Services, PA | Current | Accepting new patients | |
| Family Works Psychological Center, PLLC | Psychologist | Past | Accepting new patients |
Locations
2505 S 17th St
Ste 200
Wilmington, NC 28401
Phone (910) 231-4294
3317 Masonboro Loop Rd
Unit 160
Wilmington, NC 28409
Phone (910) 538-5334
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Wilmington, NC
- NPI 1306669494
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Wilmington, NC
- NPI 1982117669
-
- Clinical Psychologist
- Wilmington, NC
- NPI 1063488773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757289600000",
"number": "1104973890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N GADWALL CT",
"city": "HAMPSTEAD",
"state": "NC",
"postal_code": "284437159",
"telephone_number": "910-538-5334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 EASTWOOD RD",
"address_2": "SUITE 305",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284037218",
"telephone_number": "910-509-0588",
"fax_number": "910-509-0586"
}
],
"practiceLocations": [
{
"address_1": "3317 Masonboro Loop Rd Unit 160",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284092970",
"country_code": "US",
"telephone_number": "910-538-5334",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILLER-URBAN",
"first_name": "KIMBERLEE",
"middle_name": "LYNNE",
"name_prefix": "Ms.",
"credential": "MA. EDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2025-09-08",
"certification_date": "2025-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NC",
"license": "2612",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "2612",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NC",
"license": "2612",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.