Individual provider Active NPI

Nelda Jean Carol Wulf, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1467646356
Registry record updated Jul 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
989526 Issued in CO
Practice address
1339 31St Street Cir
Colorado Springs, CO 80904-1206
Phone
(719) 659-6097
Fax
(719) 578-8589
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 989526 CO Primary

Addresses

Primary practice location

1339 31St Street Cir
Colorado Springs, CO 80904-1206

Mailing address

1339 31St Street Cir
Colorado Springs, CO 80904-1206
Phone (719) 659-6097

Other names 1

  • Mrs. Jean C. Wulf Professional name

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
I20071005000761 CO Practitioner - Clinical Social Worker 5193810018 Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
989526COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310342400000",
    "number": "1467646356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 31ST STREET CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809041206",
            "telephone_number": "719-659-6097",
            "fax_number": "719-578-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 31ST STREET CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809041206",
            "telephone_number": "719-659-6097",
            "fax_number": "719-578-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WULF",
        "first_name": "NELDA JEAN",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2011-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "989526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "WULF",
            "middle_name": "C.",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.