Individual provider Active NPI

Karol Kullberg, LCSW-C

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1821045162
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
08622 Issued in MD
Practice address
12 S Adams St
Rockville, MD 20850-4238
Phone
(301) 424-1368
NPI assigned
May 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 08622 MD Primary

Addresses

Primary practice location

12 S Adams St
Rockville, MD 20850-4238

Mailing address

133 Fountain Green LN
Gaithersburg, MD 20878-7852
Phone (301) 916-0845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20040505001708 DC Practitioner - Clinical Social Worker 8022006113 Practice locations: Rockville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6230 Montrose Rd
Rockville, MD 20852-4119
Phone (301) 466-6902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821045162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 FOUNTAIN GREEN LN",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208787852",
            "telephone_number": "301-916-0845",
            "fax_number": "301-916-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S ADAMS ST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504238",
            "telephone_number": "301-424-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLBERG",
        "first_name": "KAROL",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "08622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.