Healthcare Provider Details

I. General information

NPI: 1568210441
Provider Name (Legal Business Name): KIMBERLY JANE MCDEVITT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 LUTHERAN PKWY STE 340
WHEAT RIDGE CO
80033-6039
US

IV. Provider business mailing address

3555 LUTHERAN PKWY STE 340
WHEAT RIDGE CO
80033-6039
US

V. Phone/Fax

Practice location:
  • Phone: 303-996-6005
  • Fax: 303-420-8831
Mailing address:
  • Phone: 303-996-6005
  • Fax: 303-420-8831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW09933282
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: