Individual provider Active NPI

Kimberly S Van Enk, LCSW

  • Addiction (Substance Use Disorder) Counselor
  • Raleigh, NC
National Provider Identifier
1689944142
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
3133 Quinley PL
Raleigh, NC 27604-3358
Phone
(760) 994-4990
NPI assigned
Dec 30, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 144122 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Clinical Social Worker 1041C0700X 22429-C AR
Clinical Social Worker 1041C0700X C017062 NC

Addresses

Primary practice location

3133 Quinley PL
Raleigh, NC 27604-3358

Mailing address

3133 Quinley PL
Raleigh, NC 27604-3358
Phone (310) 462-8599

Other identifiers 1

IdentifierTypeStateIssuer
190077AHNMedicaidCA

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
I20260320004142 NC Practitioner - Clinical Social Worker 7810471406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2261 Market St
San Francisco, CA 94114-1612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22429-CARMDClinical Social Worker
144122CAMDClinical Social Worker
C017062NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Substance Abuse Foundation of Long Beach Past Accepting new patients
Brightside Medical, P.C. Past Accepting new patients
Safe Refuge Past Accepting new patients

Organizations & group practices 4

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": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1689944142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 QUINLEY PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043358",
            "telephone_number": "310-462-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 QUINLEY PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276043358",
            "telephone_number": "760-994-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ENK",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "144122",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "22429-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017062",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190077AHN",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.