Kendra Colacchio Tullos, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11478 Issued in OR

Practice address

1258 High St
Eugene, OR 97401-3238

Phone

(541) 342-8437

NPI assigned

Sep 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kendra Kathleen Stubbs Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Center for Family Development, Inc.Group PAC ID 2466629217, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/c-f-d/r4/

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.

• Center for Family Development, Inc.

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1265609184
  Medicare reassignment Care Compare group NPD
• Center for Family Development, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Eugene, OR
  • NPI 1538150388
  NPD
• Oslc Community Programs

  • Adolescent and Children Mental Health Clinic/Center
  • Eugene, OR
  • NPI 1295747186
  NPD (past)

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1134770837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 HIGH ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-342-8437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 HIGH ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-342-8437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLOS",
        "first_name": "KENDRA",
        "middle_name": "COLACCHIO",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11478",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "STUBBS",
            "middle_name": "KATHLEEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sydney Tucker
• Todd S Tucker, D.M.D.,M.D.
• Anjanette N. Tuckman, LCSW
• Jennifer M Tufariello, MD
• Huiying Jessica Zhou Tull
• Colleen Tuman, N.P.
• Jeffrey M Tuman, MD
• Naomi Carol Tuman, LCSW
• Janice Tung
• Jerald Anthony Turk, C.R.N.A.

• Clinical Social Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.