Kendra Elizabeth Wickline, LCSW, LAC is a medicare enrolled "Social Worker - Clinical" provider in Lafayette, Colorado. Her current practice location is
1455 Dixon Ave, Lafayette, Colorado. You can reach out to her office (for appointments etc.) via phone at
(303) 443-8500.
Kendra Elizabeth Wickline is licensed to practice in Colorado (license number CSW.09927949) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1134608532.
Healthcare Provider's Profile
| Full Name | Kendra Elizabeth Wickline |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1455 Dixon Ave, Lafayette, Colorado |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1134608532
- Provider Enumeration Date: 08/07/2018
- Last Update Date: 11/26/2025
Medicare PECOS Information:
- PECOS PAC ID: 2769845148
- Enrollment ID: I20230901000315
Medical Identifiers
Medical identifiers for Kendra Elizabeth Wickline such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1134608532 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ACD.0001819 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW.09927949 (Colorado) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kendra Elizabeth Wickline allows following entities to bill medicare on her behalf.
| Entity Name | Mental Health Center Of Boulder County, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093767543
PECOS PAC ID: 2163314857
Enrollment ID: O20040326001284 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kendra Elizabeth Wickline is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Kendra Elizabeth Wickline, LCSW, LAC
1455 Dixon Ave,
Lafayette, CO 80026-8879
Ph: () - | Kendra Elizabeth Wickline, LCSW, LAC
1455 Dixon Ave,
Lafayette, CO 80026-8879
Ph: (303) 443-8500 |
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