METRO COMMUNITY PROVIDER NETWORK, INC. (NPI# 1699311803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699311803 |
| Entity Type | Organization |
| Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Other Organization Name | STRIDE CHC - UNION SQUARE HEALTH PLAZA AT JEFFERSON CENTER BH |
| Practice Address |
12055 W 2nd Pl Lakewood CO 80228-1506 |
| Mailing Address |
2255 S Oneida St Denver CO 80224-2522 |
| Practice Telephone | 3033606276 |
| Practice Fax Number | 3033430247 |
| Mailing Telephone | 3033606276 |
| Mailing Fax Number | 3033430247 |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2020-03-10 |
| Authorized Official Name | YOLANDA TREVINO (PATIENT ACCOUNTS MANAGER) |
| Authorized Official Telephone | 3037612153 |
| Is Organization Subpart | Y |
| Parent Organization Name | METRO COMMUNITY PROVIDER NETWORK, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| STRIDE CHC - Union Clinic at JCMH Behavioral Health | Doing Business As Name - Organization |
| STRIDE CHC - Union Square Health Plaza at Jefferson Center BH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| 1952853772 | Metro Community Provider Network, Inc. | Clinic/Center | 6303 Wadsworth Bypas, Arvada, CO 80003 | 2016-10-27 |
| 1679931646 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 South Teller Street, Lakewood, CO 80235-2014 | 2016-02-05 |
| 1558727883 | Metro Community Provider Network, Inc. | Clinic/Center | 10680 Del Mar Parkway, Aurora, CO 80010-4011 | 2015-12-31 |
| 1649605536 | Metro Community Provider Network, Inc. | Clinic/Center | 1537 Alton Street, Aurora, CO 80010-1712 | 2013-09-10 |
| 1811333842 | Metro Community Provider Network, Inc. | Clinic/Center | 1666 Elmira Street, Aurora, CO 80110-2122 | 2013-05-16 |
| 1184961492 | Metro Community Provider Network, Inc. | Clinic/Center | 7495 West 29th Avenue, Wheat Ridge, CO 80033-8002 | 2013-01-07 |
| 1568707776 | Metro Community Provider Network, Inc. | Clinic/Center | 15501 East 13th Avenue, Aurora, CO 80011-7203 | 2012-11-29 |
| 1114213972 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 West 2nd Place, Lakewood, CO 80228-1506 | 2011-06-21 |
| Street Address |
12055 W 2ND PL |
| City | LAKEWOOD |
| State | CO |
| Zip Code | 80228-1506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669495404 | Margaret Lackey | Psychiatry & Neurology | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2006-07-25 |
| 1649826215 | Valerie K Damron | Technician, Other | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2019-08-10 |
| 1083132559 | Lauren Fouch | Counselor | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2017-09-06 |
| 1487170692 | Anastasia Soroka | Counselor | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2017-08-18 |
| 1447780994 | Alison West | Counselor | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2017-06-18 |
| 1801332655 | Rachael Saffa | Social Worker | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2017-01-17 |
| 1942744388 | Paula Prentice | Psychologist | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2016-12-04 |
| 1326581257 | Theresa Tomich | Student in an Organized Health Care Education/Training Program | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2016-11-25 |
| 1376092080 | Jessica Way | Counselor | 12055 W 2nd Pl, Lakewood, CO 80228 | 2016-09-23 |
| 1164970588 | Shannon Gwash | Community Health Worker | 12055 W 2nd Pl, Lakewood, CO 80228-1506 | 2016-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174083570 | Lindsey Mae Beverly | Physician Assistant | Medical Plaza 2, 11700 W 2nd Pl, #350, Lakewood, CO 80228 | 2019-03-21 |
| 1881119931 | Cory J Frazier | Nurse Practitioner | 11600 W. 2nd Pl, Lakewood, CO 80228 | 2017-08-10 |
| 1508213885 | Chelsea Tucker | Counselor | 12157 W Cedar Dr Ste 207, Lakewood, CO 80228 | 2016-05-17 |
| 1972963841 | Shastin Gerbracht | Counselor | 12055 W 2nd Pl, Ste 200, Lakewood, CO 80228 | 2016-03-04 |
| 1073983375 | Suzanne Phillips | Behavioral Analyst | 200 Union Blvd. Ste. 200, Lakewood, Co. 80228, Denver, CO 80228 | 2015-09-29 |
| 1700265667 | April Mearsha | Doula | 12977 W Cedar Dr, 2-305, Lakewood, CO 80228 | 2015-05-26 |
| 1306233713 | Caleb Hedberg | Internal Medicine | 165 S Union Blvd Ste 800, Lakewood, CO 80228 | 2015-04-23 |
| 1972996288 | David Lindsey Currie | Counselor | 12055 W 2nd Place, Jefferson Ctr for Mental Health, Lakewood, CO 80228 | 2015-03-11 |
| 1619365533 | Michelle Broberg II | Technician | 12055 West 2nd Plaza, Lakewood, CO 80228 | 2014-12-30 |
| 1750789012 | Kayla Morrison | Social Worker | 12005 W 2nd Place, Lakewood, CO 80228 | 2014-12-18 |
| Find all providers in zip 80228 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861014805 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 S Teller St Fl 4, Lakewood, CO 80235-2014 | 2020-05-13 |
| 1033755392 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 W 2nd Pl # 200, Lakewood, CO 80228-1506 | 2019-11-21 |
| 1518437474 | Lakewood Resource and Referral Center, Inc. | Clinic/Center | 485 Locust St, Lakewood, NJ 08701-5896 | 2018-12-04 |
| 1679931646 | Metro Community Provider Network, Inc. | Clinic/Center | 3595 South Teller Street, Lakewood, CO 80235-2014 | 2016-02-05 |
| 1114213972 | Metro Community Provider Network, Inc. | Clinic/Center | 12055 West 2nd Place, Lakewood, CO 80228-1506 | 2011-06-21 |
| 1558526418 | Metro Community Provider Network, Inc. | Clinic/Center | 8755 West 14th Avenue, Lakewood, CO 80215-4863 | 2008-07-21 |
| 1437314481 | Metro Community Provider Network, Inc. | Clinic/Center | 1255 South Wadsworth Blvd., Lakewood, CO 80232-5406 | 2008-07-18 |
| 1992965420 | Metro Community Provider Network, Inc. | Clinic/Center | 8500 West Colfax Avenue, Lakewood, CO 80215-4011 | 2008-06-09 |
| 1699778233 | The Lakes Community Health Center, Inc | Clinic/Center | 15397 State Highway 32, Lakewood, WI 54138-9702 | 2005-05-27 |
| 1710980917 | Ocean Health Initiatives | Clinic/Center | 101 2nd St, Lakewood, NJ 08701-3324 | 2005-05-23 |
| Find all providers in LAKEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.