Individual provider Active NPI

Melanie Carron Kulick, LSCSW, LCAC, LCSW

  • Clinical Social Worker
  • Leawood, KS
National Provider Identifier
1821516634
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05546 Issued in KS
Practice address
8700 State Line Rd Ste 324
Leawood, KS 66206-1572
Phone
(913) 907-9339
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 05546 KS Primary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 00806 KS
Clinical Social Worker 1041C0700X 2022032276 MO

Addresses

Primary practice location

8700 State Line Rd Ste 324
Leawood, KS 66206-1572

Mailing address

1120 W 77TH St
Kansas City, MO 64114-1658
Phone (913) 907-9339

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
00806KSMDAddiction (Substance Use Disorder) Counselor
05546KSMDClinical Social Worker
2022032276MOMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1821516634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 W 77TH ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641141658",
            "telephone_number": "913-907-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 STATE LINE RD STE 324",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662061572",
            "telephone_number": "913-907-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULICK",
        "first_name": "MELANIE",
        "middle_name": "CARRON",
        "name_prefix": "Mrs.",
        "credential": "LSCSW, LCAC, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "05546",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "00806",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022032276",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.