Organization Active NPI

Kimberly M Selsky Lcmhc PLLC

  • Mental Health Counselor
  • Wilmington, NC
National Provider Identifier
1841068475
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KIMBERLY M SELSKY LCMHC PLLC
Practice address
5010 Randall Pkwy
Wilmington, NC 28403-2829
Phone
(910) 791-5719
Fax
(910) 799-8180
NPI assigned
Dec 13, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Authorized official

Name
Rebecca Mullins
Title
Practice Manager
Phone
(910) 791-5719

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5010 Randall Pkwy
Wilmington, NC 28403-2829

Mailing address

5010 Randall Pkwy
Wilmington, NC 28403-2829
Phone (910) 791-5719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240328000713 NC Part B Supplier - Clinic/Group Practice 9638516461 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1841068475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 RANDALL PKWY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032829",
            "telephone_number": "910-791-5719",
            "fax_number": "910-799-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 RANDALL PKWY",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284032829",
            "telephone_number": "910-791-5719",
            "fax_number": "910-799-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY M SELSKY LCMHC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "910-791-5719"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.