Individual provider Active NPI

Jennifer Ann Kullby, LCSW, LAC

  • Clinical Social Worker
  • Littleton, CO
National Provider Identifier
1821718446
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09932637 Issued in CO
Practice address
5500 S Sycamore St
Littleton, CO 80120-1132
Phone
(303) 730-8858
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0002803 CO
Clinical Social Worker 1041C0700X CSW.09932637 CO Primary

Addresses

Primary practice location

5500 S Sycamore St
Littleton, CO 80120-1132

Mailing address

116 Inverness Dr E Ste 105
Englewood, CO 80112-5125
Phone (303) 730-8858

Other practice location 1

4141 E Dickenson Pl
Denver, CO 80222-6012
Phone (303) 504-6565

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
I20260528000818 CO Practitioner - Clinical Social Worker 4981174273 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

116 Inverness Dr E
Suite 105
Englewood, CO 80112-5125

4141 E Dickenson PL
Denver, CO 80222-6012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD.0002803COMDAddiction (Substance Use Disorder) Counselor
CSW.09932637COMDClinical Social Worker

Organizations & group practices 2

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1821718446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 INVERNESS DR E STE 105",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801125125",
            "telephone_number": "303-730-8858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 S SYCAMORE ST",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801201132",
            "telephone_number": "303-730-8858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4141 E Dickenson Pl",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802226012",
            "country_code": "US",
            "telephone_number": "303-504-6565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KULLBY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LCSW, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0002803",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09932637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.