Provider Demographics
NPI:1467796615
Name:ALSTON, ROY BRYAN (MFT)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:BRYAN
Last Name:ALSTON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 E 145TH AVE
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-5699
Mailing Address - Country:US
Mailing Address - Phone:303-204-8162
Mailing Address - Fax:
Practice Address - Street 1:11844 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-2504
Practice Address - Country:US
Practice Address - Phone:303-204-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-11
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist