Organization Active NPI

Road to Me Recovery Services

  • Clinic/Center
  • Arvada, CO
National Provider Identifier
1407510357
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ROAD TO ME RECOVERY SERVICES
Practice address
10050 Ralston Rd # 1
Arvada, CO 80004-4974
Phone
(720) 583-6145
NPI assigned
Oct 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Katie Brydon, LCSW, LAC, MACNPI 1619308194
Title
Therapist
Phone
(720) 401-2340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Clinic/Center 261Q00000X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

10050 Ralston Rd # 1
Arvada, CO 80004-4974

Mailing address

11857 Keough Dr
Northglenn, CO 80233-1221
Phone (720) 401-2340

Other practice location 1

11857 Keough Dr
Northglenn, CO 80233-1221
Phone (720) 401-2340

Other practice location 2

11857 Keough Dr
Northglenn, CO 80233-1221
Phone (720) 401-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211220000284 CO Part B Supplier - Clinic/Group Practice 0749671154 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Arvada, CO

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Road to Me Recovery Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10050 Ralston Rd
Ste 1B
Arvada, CO 80004

Practitioners & affiliated clinicians

Practitioners 4

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": "1635292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1407510357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11857 KEOUGH DR",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802331221",
            "telephone_number": "720-401-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 RALSTON RD # 1",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800044974",
            "telephone_number": "720-583-6145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11857 Keough Dr",
            "address_purpose": "LOCATION",
            "city": "Northglenn",
            "state": "CO",
            "postal_code": "802331221",
            "country_code": "US",
            "telephone_number": "720-401-2340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11857 Keough Dr",
            "address_purpose": "LOCATION",
            "city": "Northglenn",
            "state": "CO",
            "postal_code": "802331221",
            "country_code": "US",
            "telephone_number": "720-401-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROAD TO ME RECOVERY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-27",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "BRYDON",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "720-401-2340",
        "authorized_official_credential": "LCSW, LAC, MAC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arvada, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.