Roberta Lorraine Casaday

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

302270 Issued in MN

Practice address

435 Bean Ave
Mora, MN 55051-1402

Phone

(281) 491-3086

NPI assigned

Jan 26, 2023

Sex

Female

Sole proprietor

Yes

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.

• Serenity Manor

  • Substance Abuse Rehabilitation Facility
  • Mora, MN
  • NPI 1689928319
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 26, 2023.

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1558077222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MAPLE AVE E",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511311",
            "telephone_number": "320-679-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 BEAN AVE",
            "city": "MORA",
            "state": "MN",
            "postal_code": "550511402",
            "telephone_number": "281-491-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASADAY",
        "first_name": "ROBERTA",
        "middle_name": "LORRAINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcasaday@truedirections.org",
            "affiliation": "Y",
            "endpointDescription": "business email",
            "affiliationName": "Serenity Manor",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "206 Maple Ave E",
            "city": "Mora",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550511311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lori Braiedy, MA CCC-SLP
• Sadie Briana Broekemeier, LPCC
• Joseph John Buckley, CRNA
• Aimee Burk
• Tanya Lynn Carlson, AGPCNP
• Teresa M Clark, OTR
• Coborns Inc
• Coborns Inc
• Benjamin Bryan Coleman, LPCC
• Renee L Coleman, PAC

• All providers in Mora, MN
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.