Kimberly Dawn Clark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C020424 Issued in NC

Practice address

1436 Highland Dr
Washington, NC 27889-3222

Phone

(252) 946-1902

Fax

(252) 946-8430

NPI assigned

Oct 6, 2022

Sex

Female

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Beaufort

  • Public Health or Welfare Agency
  • Washington, NC
  • NPI 1679576763
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 2, 2026.

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1144945783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 HIGHLAND DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893222",
            "telephone_number": "252-946-1902",
            "fax_number": "252-946-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 HIGHLAND DR",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893222",
            "telephone_number": "252-946-1902",
            "fax_number": "252-946-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C020424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Chigavazira, PT
• Faith Lorraine Christian, MSW
• City of Washington Finance Director
• Debra Stein Clancy, M.D.
• Allen Hunt Clark
• Lanika Clark
• CNC/Access Inc
• CNC/Access Inc
• CNC/Access, Inc.
• CNC/Access, Inc.

• All providers in Washington, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.