Individual provider Active NPI

Molly Klekamp, MSW, LCSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1740748243
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
09925856 Issued in CO
Practice address
3050 Broadway St Ste 300
Boulder, CO 80304-3189
Phone
(303) 667-6647
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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 09925856 CO Primary

Addresses

Primary practice location

3050 Broadway St Ste 300
Boulder, CO 80304-3189

Mailing address

3050 Broadway St Ste 300
Boulder, CO 80304-3189
Phone (303) 667-6647

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
I20191127000255 CO Practitioner - Clinical Social Worker 5193158400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09925856COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Wolf Wisdom LLC Clinical Current 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": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1740748243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 BROADWAY ST STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043189",
            "telephone_number": "303-667-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 BROADWAY ST STE 300",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043189",
            "telephone_number": "303-667-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEKAMP",
        "first_name": "MOLLY",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "09925856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.