PASSPORT AUTISM LLC (NPI# 1760957138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760957138 |
| Entity Type | Organization |
| Organization Name | PASSPORT AUTISM LLC |
| Practice Address |
912 Driftwood Dr Fort Collins CO 80525 |
| Mailing Address |
912 Driftwood Dr Fort Collins CO 80525-3106 |
| Practice Telephone | 9704603495 |
| Mailing Telephone | 9704603495 |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2019-11-12 |
| Authorized Official Name | MR. DAVID E HUGHES (FOUNDER) |
| Authorized Official Telephone | 3153170825 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 327 Riva Ridge Dr Apt D308, Fort Collins, CO 805266381 | 3153170825 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Passport Autism LLC | 912 Driftwood Drive, Fort Collins, CO 80525 |
| Street Address |
912 DRIFTWOOD DR |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205266319 | David Eugene Hughes | Behavioral Analyst | 912 Driftwood Dr, Fort Collins, CO 80525 | 2013-11-26 |
| 1780299222 | Mccaili Giauque | Behavior Technician | 912 Driftwood Dr, Fort Collins, CO 80525-3106 | 2020-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356950299 | Kelly Westbrook Schmalstich | Clinical Nurse Specialist | 2020 Blue Yonder Way, Fort Collins, CO 80525 | 2020-07-27 |
| 1912522376 | Tender Gifts Midwifery and Birth Center | Clinical Nurse Specialist | 1817 Jessup Dr Farms, Fort Collins, CO 80525 | 2020-06-11 |
| 1114566015 | Andrea Nicole Brogdon | Acupuncturist | 2501 S. College Ave, Fort Collins, CO 80525 | 2019-12-26 |
| 1013553593 | Kids Overcoming, LLC | Home Health | 1330 Oakridge Drive Suite 105, Fort Collins, CO 80525 | 2019-11-20 |
| 1568019966 | Julia Heithoff | Behavioral Analyst | 1100 Haxton Dr #115, Fort Collins, CO 80525 | 2019-08-20 |
| 1144875246 | Harmony Smiles Dentistry, LLP | Dentist | 356 E Harmony Rd., #6-a, Fort Collins, CO 80525 | 2019-08-06 |
| 1841774502 | Shannon L Harris | Social Worker | 305 Carpenter Road, Fort Collins, CO 80525 | 2018-09-19 |
| 1306332101 | Joshua Evans Brooks | Optometrist | 375 E Horsetooth Rd Bldg 5 Ste 201, Fort Collins, CO 80525 | 2018-07-03 |
| 1285120212 | Danae Fuqua | Physical Medicine & Rehabilitation | Covell Care & Rehabilitation, 2350 Limon Dr., Fort Collins, CO 80525 | 2018-07-02 |
| 1528552890 | Megan E Locke | Audiologist | 724 Whalers Way Bdg I, Suite 101, Fort Collins, CO 80525 | 2018-06-19 |
| Find all providers in zip 80525 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194330928 | Michelle Garcia Lmft | Community/Behavioral Health | 304 Albion Way, Fort Collins, CO 80526-3238 | 2020-09-09 |
| 1760017768 | Guided Pathways | Community/Behavioral Health | 145 N College Ave Ste O, Fort Collins, CO 80524-2443 | 2020-03-10 |
| 1962036731 | Cultivating Hope Counseling LLC | Community/Behavioral Health | 3532 E Prospect Rd, Fort Collins, CO 80525-9738 | 2020-03-02 |
| 1982113718 | Friends of L'arche Fort Collins | Community/Behavioral Health | 4500 Seneca St Unit 71, Fort Collins, CO 80526 | 2017-09-25 |
| 1386162626 | Team Fort Collins Inc. | Community/Behavioral Health | 201 S College Ave # 400, Fort Collins, CO 80524-3182 | 2017-09-07 |
| 1932647146 | Colorado State University | Community/Behavioral Health | 1876 Campus Delivery, Colorado State University, Fort Collins, CO 80523-1876 | 2017-02-08 |
| 1811441447 | Astraea Counseling Services | Community/Behavioral Health | 3827 Precision Dr, Unit A, Fort Collins, CO 80528-4597 | 2016-08-11 |
| 1316307606 | Reyes Corporation | Community/Behavioral Health | 3000 S College Ave Unit 202, Fort Collins, CO 80525-2558 | 2016-02-29 |
| 1841684313 | Kinzie Counseling Pllc | Community/Behavioral Health | 2121 E Harmony Rd Unit 250, Fort Collins, CO 80528-3402 | 2015-03-23 |
| 1265661169 | Beyond The Mirror | Community/Behavioral Health | 1031 Robertson St, Fort Collins, CO 80524-3926 | 2009-07-13 |
| Find all providers in FORT COLLINS | ||||
| City | FORT COLLINS |
| Zip Code | 80525 |
Please comment or provide details below to improve the information on PASSPORT AUTISM LLC.
| 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.