DR. AMY DEXTER KENNICUTT PSY.D.
NPI 1407184401
Psychologist in Littleton, CO

Active since December 02, 2009Opted out of Medicare · through Nov 19, 2027
5753 S PRINCE ST, LITTLETON, CO 80120(970) 368-5552 Get Directions Write a Review

NPPES record last updated: December 14, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 14, 2020, Aug 21, 2020 (2 updates tracked since 2020).

About Dr. Amy Dexter Kennicutt Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AMY DEXTER KENNICUTT PSY.D. (NPI 1407184401) is an individual psychologist in Littleton, Colorado and active in the NPI registry since December 2009. She has opted out of Medicare through November 19, 2027 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1407184401
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. AMY DEXTER KENNICUTTCredential: PSY.D.
Location Address5753 S PRINCE STLittleton, CO 80120-1927
Mailing AddressPo Box 1172Littleton, CO 80160-1172 · (970) 368-5552
Sole ProprietorNo
Enumeration DateDecember 2, 2009
Last NPPES UpdateDecember 14, 20202 updates tracked since enumeration
NPPES CertifiedDecember 14, 2020
NPI 1407184401 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 4953 (CO)
5753 S PRINCE ST, Littleton, CO 80120

Secondary Practice Locations 2

Location 13020 Carbon PlBoulder, CO 80301-6169 · Phone (970) 368-5552
Location 24956 S Prince Ct Apt 304Littleton, CO 80123-7792 · Phone (970) 368-5552

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Amy Dexter Kennicutt Psy.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 19, 2015 through November 19, 2027.

Opt-Out Effective DateNovember 19, 2015
Opt-Out In Effect ThroughNovember 19, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407184401, enumerated as an "individual" on December 02, 2009.

The provider is located at 5753 S PRINCE ST LITTLETON, CO 80120 and the phone number is (970) 368-5552.

Psychologist with taxonomy code 103T00000X.