Active NPI
Grae Ferrer Roda
- Mental Health Counselor
- Broomfield, CO
National Provider Identifier
1023613494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPCC.0021852
- Practice address
- 125 Breckenridge TRL
Broomfield, CO 80020-9679 - Phone
- (720) 840-0191
- NPI assigned
- Dec 2, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPCC.0021852 | CO | Primary |
Addresses
Primary practice location
125 Breckenridge TRL
Broomfield, CO 80020-9679
Mailing address
125 Breckenridge TRL
Broomfield, CO 80020-9679
Phone (720) 840-0191
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5353 W Dartmouth Ave
Suite 305
Denver, CO 80227-5515
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC.0021852 | CO | MD | Mental Health Counselor |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Denver, CO
- NPI 1477161495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713139200000",
"number": "1023613494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 BRECKENRIDGE TRL",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800209679",
"telephone_number": "720-840-0191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 BRECKENRIDGE TRL",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800209679",
"telephone_number": "720-840-0191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODA",
"first_name": "GRAE",
"middle_name": "FERRER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-02",
"last_updated": "2024-04-15",
"certification_date": "2024-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "LPCC.0021852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.