Kaitlin Marie Wickstrom, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

325 King St
Denver, CO 80219-1326

Phone

(720) 537-5168

NPI assigned

Sep 23, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Savio House, Inc.

  • Professional Counselor
  • Denver, CO
  • NPI 1023132263
  NPD (past)
• Life Works Counseling

  • Marriage & Family Therapist
  • Bloomingdale, GA
  • NPI 1831482678
  NPD (past)

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1356957443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 KING ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802191326",
            "telephone_number": "720-537-5168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 KING ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802191326",
            "telephone_number": "720-537-5168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKSTROM",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna-Lisa Wick, PSYCHIATRIC NP-BC
• Wendy Wicke, RN
• Amanda Wickenkamp, OTR
• Julia Wicker, MA
• Jeffrey D Wicks, M.D.
• Susan Lynn Wickware, COTA
• William Widdison, P.T.
• Nanette L Widdle
• Hiram Emory Widener III, LPCC
• Nichol Lee Widga, BA

• Mental Health Counselor in Denver, CO
• Providers in Denver, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.

Verify at the official NPI Registry.