Active NPI
Kimberly L. Maddux, MSW, LCSW, LAC
- Clinical Social Worker
- Denver, CO
National Provider Identifier
1245201839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 992213
- Practice address
- 4455 E 12TH Ave
Denver, CO 80220-2415 - Phone
- (303) 504-7710
- Fax
- (303) 504-7792
- NPI assigned
- Jan 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 171 | CO | |
| Clinical Social Worker | 1041C0700X | 992213 | CO | Primary |
Addresses
Primary practice location
4455 E 12TH Ave
Denver, CO 80220-2415
Mailing address
4141 E Dickenson PL
Denver, CO 80222-6012
Phone (303) 504-6509
Other names 1
- Kimberly L. Kaufman
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040525001007 | CO | Practitioner - Clinical Social Worker | 8921089152 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171 | CO | MD | Clinical Social Worker |
| 992213 | CO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Center of Denver | Current | Accepting new patients | |
| Mental Health Center of Denver | Current | Accepting new patients | |
| Mental Health Center of Denver | Current | Accepting new patients |
Locations
4141 E Dickenson Pl
Denver, CO 80222
Phone (303) 504-6509
4455 E 12th Ave
Denver, CO 80220
Phone (303) 504-7782
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Denver, CO
- NPI 1396566444
CO
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Denver, CO
- NPI 1407643679
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Denver, CO
- NPI 1922829100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565136000000",
"number": "1245201839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4141 E DICKENSON PL",
"city": "DENVER",
"state": "CO",
"postal_code": "802226012",
"telephone_number": "303-504-6509",
"fax_number": "303-782-0916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4455 E 12TH AVE",
"city": "DENVER",
"state": "CO",
"postal_code": "802202415",
"telephone_number": "303-504-7710",
"fax_number": "303-504-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDUX",
"first_name": "KIMBERLY",
"middle_name": "L.",
"credential": "MSW, LCSW, LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-31",
"last_updated": "2019-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "171",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CO",
"license": "992213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "KAUFMAN",
"middle_name": "L.",
"credential": "MSW, LCSW, LAC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.