Organization Active NPI

Road to Independence

  • Mental Health Occupational Therapist
  • Middletown, CT
National Provider Identifier
1093523912
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Occupational TherapistTaxonomy code 225XM0800X
Legal business name
ROAD TO INDEPENDENCE
Practice address
769 Newfield St Ste 4
Middletown, CT 06457-1846
Phone
(203) 376-6640
NPI assigned
Dec 23, 2024
Organization subpart
Yes
Parent organization
LYNN COALSON, OTR/L, M.ED., CBTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lynn A Coalson, OTR/L, M.ED., CBT
Title
Owner
Phone
(203) 376-6640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XM0800X Primary

Addresses

Primary practice location

769 Newfield St Ste 4
Middletown, CT 06457-1846

Mailing address

92 Kimberly Rd
East Granby, CT 06026-9540
Phone (203) 376-6640

Other practice location 1

28 School St Ste F2
East Granby, CT 06026-9769
Phone (203) 376-6640

Other names 1

  • Road to Indepdence Doing business as

National Provider Directory

National Provider Directory
Part of
Road to Independence

Locations

28 School St
Ste F2
East Granby, CT 06026
Phone (203) 376-6640

769 Newfield St
Ste 4
Middletown, CT 06457
Phone (203) 376-6640

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1093523912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 KIMBERLY RD",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060269540",
            "telephone_number": "203-376-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 NEWFIELD ST STE 4",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064571846",
            "telephone_number": "203-376-6640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 School St Ste F2",
            "address_purpose": "LOCATION",
            "city": "East Granby",
            "state": "CT",
            "postal_code": "060269769",
            "country_code": "US",
            "telephone_number": "203-376-6640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROAD TO INDEPENDENCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LYNN COALSON, OTR/L, M.ED., CBT",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "COALSON",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-376-6640",
        "authorized_official_credential": "OTR/L, M.ED., CBT"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Road to Indepdence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.