Kimberly E Ellis, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C011215 Issued in NC

Practice address

811 Central Ave Ste 8
Charlotte, NC 28204-2015

Phone

(484) 868-0226

NPI assigned

Nov 5, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1457724841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 CENTRAL AVE STE 8",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042015",
            "telephone_number": "484-868-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CENTRAL AVE STE 8",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042015",
            "telephone_number": "484-868-0226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 Berryfield Dr",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274109980",
            "country_code": "US",
            "telephone_number": "484-868-0226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KIMBERLY",
        "middle_name": "E",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-05",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David E Ellis III
• Dee Ann Ellis, MD
• Evelyn Ellis, MA, LMFT
• Jared Michael Ellis, LPN
• Keenya Ellis
• Margaret Bryan Ellis, DO
• Mark C. Ellis, M.D.
• Melissa Ellis, CRNA
• Morgan E. Ellis, LCSWA
• Paul W Ellis, P.A.

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.