Individual provider Active NPI

Kimberly Kleisch, MS, LCAS, CCS

  • Addiction (Substance Use Disorder) Counselor
  • Greensboro, NC
National Provider Identifier
1518503168
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
24189 Issued in NC
Practice address
1001 Western Gaines LN Apt 3F
Greensboro, NC 27409-9868
Phone
(336) 580-1970
NPI assigned
Nov 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X 24189 NC
Addiction (Substance Use Disorder) Counselor 101YA0400X 24189 NC Primary

Addresses

Primary practice location

1001 Western Gaines LN Apt 3F
Greensboro, NC 27409-9868

Mailing address

1001 Western Gaines LN Apt 3F
Greensboro, NC 27409-9868
Phone (336) 580-1970

Other identifiers 1

IdentifierTypeStateIssuer
24189OtherNCNORTH CAROLINA

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Greensboro Health Information Exchange (HIE) New Vision Therapy PLLC

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
I20240712001211 NC Practitioner - Mental Health Counselor 4385189422 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
24189NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Plur-Ing LLC Addiction (Substance Use Disorder) CurrentSince Jul 1, 2025 Accepting new patients
Saved Health Inc Addiction (Substance Use Disorder) CurrentSince Apr 28, 2026 Accepting new patients

Locations

3755 Admiral Dr
Ste 105A
High Point, NC 27265
Phone (336) 210-8409

Organizations & group practices 2

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": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764806400000",
    "number": "1518503168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WESTERN GAINES LN APT 3F",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099868",
            "telephone_number": "336-580-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WESTERN GAINES LN APT 3F",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274099868",
            "telephone_number": "336-580-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEISCH",
        "first_name": "KIMBERLY",
        "credential": "MS, LCAS, CCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "NC",
            "license": "24189",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "24189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA",
            "identifier": "24189",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Greensboro",
            "affiliation": "Y",
            "affiliationName": "New Vision Therapy PLLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Greensboro, NC",
            "address_1": "810 Warren St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274032340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.