Individual provider Active NPI

Kimberly Anne Worsham, LPC

  • Professional Counselor
  • Evergreen, CO
National Provider Identifier
1134840275
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0021328 Issued in CO
Practice address
31207 Keats Way Ste 202
Evergreen, CO 80439-2220
Phone
(303) 425-0300
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC.0021328 CO Primary

Addresses

Primary practice location

31207 Keats Way Ste 202
Evergreen, CO 80439-2220

Mailing address

31207 Keats Way Ste 202
Evergreen, CO 80439-2220
Phone (303) 425-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20241030000105 CO Practitioner - Mental Health Counselor 6406389410 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson Center for Mental HealthGroup PAC ID 9032018882, 97 clinicians

Practice addresses (Care Compare)

4851 Independence St
Suite 100
Wheat Ridge, CO 80033-6711
Phone (303) 425-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC.0021328COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Center for Mental Health Mental Health CurrentSince Sep 25, 2024 Accepting new patients
Jefferson Center for Mental Health CurrentSince Sep 25, 2024 Accepting new patients
Inn Between Past Accepting new patients

Locations

16280 W 64th Ave
Arvada, CO 80007
Phone (720) 898-1110

31207 Keats Way
Ste 202
Evergreen, CO 80439
Phone (303) 432-5300

4851 Independence St
Wheat Ridge, CO 80033
Phone (303) 432-5115

4851 Independence St
Ste 100
Wheat Ridge, CO 80033
Phone (303) 456-5495

Organizations & group practices 3

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1134840275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31207 KEATS WAY STE 202",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804392220",
            "telephone_number": "303-425-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31207 KEATS WAY STE 202",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804392220",
            "telephone_number": "303-425-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSHAM",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0021328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen, CO

Sources for this page

Verify at the official NPI Registry.