Individual provider Active NPI

Kimberly L Cook, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1215633490
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016267 Issued in NC
Practice address
5306 NC Highway 55 Ste 105
Durham, NC 27713-7812
Phone
(919) 457-1517
Fax
(919) 363-7697
NPI assigned
Jan 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 13357 SC
Clinical Social Worker 1041C0700X C016267 NC Primary

Addresses

Primary practice location

5306 NC Highway 55 Ste 105
Durham, NC 27713-7812

Mailing address

5306 NC Highway 55 Ste 105
Durham, NC 27713-7812
Phone (919) 457-1517

Other practice location 1

4975 LaCross Rd Ste 351
North Charleston, SC 29406-6530
Phone (855) 284-7483

Other practice location 2

3205 Randall Pkwy Ste 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240918002287 NC Practitioner - Clinical Social Worker 8224579271 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifesource of North CarolinaGroup PAC ID 7416132428, 172 clinicians

Practice addresses (Care Compare)

3205 Randall Pkwy
Suite 105
Wilmington, NC 28403-2565
Phone (910) 742-9243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13357SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Health and Education Partners PLLC Social Worker CurrentSince Aug 7, 2024 Accepting new patients
Pathways Human Services of North Carolina, LLC Social Worker CurrentSince Jul 13, 2024 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Aug 27, 2025 Accepting new patients
Pathways Human Services of North Carolina, LLC Social Worker Current Accepting new patients
Anchor Psychological & Counseling Services PLLC CurrentSince Dec 17, 2024 Accepting new patients
Pathways Human Services of North Carolina, LLC Social Worker CurrentSince Jul 13, 2024 Accepting new patients
Lifesource of North Carolina Clinical CurrentSince Aug 27, 2025 Accepting new patients

Locations

5306 NC Highway 55
Ste 1
Durham, NC 27713
Phone (919) 457-1517

5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517

621 Huntsman Ct
Gastonia, NC 28054
Phone (704) 671-4487

16581 US Highway 17
Ste 600
Hampstead, NC 28443
Phone (910) 270-9995

8390 Six Forks Rd
Ste 201
Raleigh, NC 27615
Phone (919) 782-8730

1442 Military Cutoff Rd
Unit B
Wilmington, NC 28403
Phone (252) 822-4150

3205 Randall Pkwy
Ste 105
Wilmington, NC 28403
Phone (910) 338-2880

5040 New Centre Dr
Ste D
Wilmington, NC 28403
Phone (910) 392-4881

Organizations & group practices 7

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1215633490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 NC HIGHWAY 55 STE 105",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137812",
            "telephone_number": "919-457-1517",
            "fax_number": "919-363-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 NC HIGHWAY 55 STE 105",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137812",
            "telephone_number": "919-457-1517",
            "fax_number": "919-363-7697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4975 LaCross Rd Ste 351",
            "address_purpose": "LOCATION",
            "city": "North Charleston",
            "state": "SC",
            "postal_code": "294066530",
            "country_code": "US",
            "telephone_number": "855-284-7483",
            "fax_number": "617-807-0958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3205 Randall Pkwy Ste 105",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284032565",
            "country_code": "US",
            "telephone_number": "910-742-9243",
            "fax_number": "888-746-1787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SC",
            "license": "13357",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.