Individual provider Active NPI

Kathleen C Kullman

  • Addiction (Substance Use Disorder) Counselor
  • Annapolis, MD
National Provider Identifier
1316658800
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
SC3013 Issued in MD
Practice address
1819 Bay Ridge Ave
Annapolis, MD 21403-2835
Phone
(443) 433-5900
NPI assigned
Dec 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X SC3013 MD Primary

Addresses

Primary practice location

1819 Bay Ridge Ave
Annapolis, MD 21403-2835

Mailing address

219 Hanover St Apt 3
Annapolis, MD 21401-1647

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL arundellodge.org Direct
CONNECT URL arundellodge.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SC3013MDMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Arundel Lodge, Inc Addiction (Substance Use Disorder) PastSince Apr 1, 2025 Accepting new patients

Organizations & group practices 1

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": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1316658800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 HANOVER ST APT 3",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BAY RIDGE AVE",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214032835",
            "telephone_number": "443-433-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLMAN",
        "first_name": "KATHLEEN",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "SC3013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "arundellodge.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1819 Bay Ridge Ave",
            "city": "Annapolis",
            "state": "MD",
            "country_code": "US",
            "postal_code": "214032835",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "arundellodge.org",
            "affiliation": "N",
            "endpointDescription": "arundellodge.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1819 Bay Ridge Ave",
            "city": "Annapolis",
            "state": "MD",
            "country_code": "US",
            "postal_code": "214032835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.