Marie Claire Roderick PSYD LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MARIE CLAIRE RODERICK PSYD LLC

Practice address

12591 Whippoorwill St
Broomfield, CO 80020-7919

Phone

(571) 276-8939

NPI assigned

Sep 21, 2022

Last updated

Oct 17, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marie Claire Roderick, PSYDNPI 1851750376

Title

Clinical Psychologist

Phone

(571) 234-8106

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marie Claire Roderick, PSYD

  • Psychologist
  • Broomfield, CO
  • NPI 1851750376
  NPD Authorized official

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1174246466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 756",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800380756",
            "telephone_number": "571-234-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12591 WHIPPOORWILL ST",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800207919",
            "telephone_number": "571-276-8939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2522 Rockbridge Dr",
            "address_purpose": "LOCATION",
            "city": "Highlands Ranch",
            "state": "CO",
            "postal_code": "801292223",
            "country_code": "US",
            "telephone_number": "571-276-8939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARIE CLAIRE RODERICK PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "RODERICK",
        "authorized_official_first_name": "MARIE CLAIRE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "571-234-8106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA STATE LICENSE TO PRACTICE AS A CLINICAL PSYCHOLOGIST",
            "identifier": "0810005301",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF COLORADO STATE LICENSE TO PRACTICE CLINICAL PSYCHOLOGY",
            "identifier": "0005553",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1851750376",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://marieclaireroderickpsyd.clientsecure.me",
            "affiliation": "N",
            "address_1": "12591 Whippoorwill St",
            "city": "Broomfield",
            "state": "CO",
            "country_code": "US",
            "postal_code": "800207919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Marcisz, MA, NCC, LPC
• Christine Marie Maren, DO
• Andrea Nicole Margheim, LPCC
• Catherine Keating Maria, M.S., N.C.C.
• Megan Maricle, PTA
• William Roger Markel, M.D.
• Jason P Markle, D.O.
• James Joseph Marr Jr., MD
• Molly Ann Marr
• Judith H Marrocco, OD

• Adult Mental Health Clinic/Center in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Adult Mental Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.