MEDICARE: MR. MICHAEL TODD KILMER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	25615	CA
2	104100000X	Social Worker	25615	CA

General Provider Information

NPI Number	:	1417978446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL TODD KILMER LCSW

Provider Business Mailing Address
First Line	:	700 COLORADO BLVD # 105
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-4084
Country	:	US
Telephone Number	:	619-889-6955
Fax Number	:

Provider Business Practice Location Address
First Line	:	1385 CHERRY ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80220-2433
Country	:	US
Telephone Number	:	619-889-6955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	04/06/2026

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