Individual provider Active NPI

Matthew Robards Hodge

  • Professional Counselor
  • Lakewood, CO
National Provider Identifier
1821498056
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0013889 Issued in CO
Practice address
12055 W 2ND PL
Lakewood, CO 80228-1506
Phone
(303) 425-0300
Fax
(303) 432-5071
NPI assigned
Aug 25, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0001379 CO
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 0013889 CO Primary

Addresses

Primary practice location

12055 W 2ND PL
Lakewood, CO 80228-1506

Mailing address

4851 Independence St
Suite 200
Wheat Ridge, CO 80033-6715
Phone (303) 425-0300

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240327004090 CO Practitioner - Mental Health Counselor 5092152892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jefferson Center for Mental HealthGroup PAC ID 9032018882, 97 clinicians

Practice addresses (Care Compare)

9485 W Colfax Ave
Lakewood, CO 80215-3918
Phone (303) 425-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001379COMDAddiction (Substance Use Disorder) Counselor
0013889COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Center for Mental Health Mental Health CurrentSince Feb 12, 2024 Accepting new patients
Jefferson Center for Mental Health CurrentSince Feb 12, 2024 Accepting new patients

Locations

16280 W 64th Ave
Arvada, CO 80007
Phone (720) 898-1110

12055 W 2nd Pl
Fl 2
Lakewood, CO 80228

9485 W Colfax Ave
Lakewood, CO 80215
Phone (303) 432-5200

12055 W 2nd Pl
Lakewood, CO 80228
Phone (303) 425-4480

4851 Independence St
Wheat Ridge, CO 80033
Phone (303) 432-5115

4851 Independence St
Ste 100
Wheat Ridge, CO 80033
Phone (303) 456-5495

4851 Independence St
Ste 200
Wheat Ridge, CO 80033

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1821498056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4851 INDEPENDENCE ST",
            "address_2": "SUITE 200",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336715",
            "telephone_number": "303-425-0300",
            "fax_number": "303-432-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12055 W 2ND PL",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802281506",
            "telephone_number": "303-425-0300",
            "fax_number": "303-432-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "MATTHEW",
        "middle_name": "ROBARDS",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-25",
        "last_updated": "2021-04-13",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "0001379",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "0013889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.