YOUTHCENTRIX THERAPY SERVICES (NPI# 1265977490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265977490 |
| Entity Type | Organization |
| Organization Name | YOUTHCENTRIX THERAPY SERVICES |
| Practice Address |
12 Saffrin Hill Ct Glen Carbon IL 62034-1561 |
| Mailing Address |
1 Oak Dr #203 Maryville IL 62062-7004 |
| Practice Telephone | 4696626729 |
| Enumeration Date | 2016-12-26 |
| Last Update Date | 2016-12-29 |
| Authorized Official Name | PAMELA LONG (MANAGER) |
| Authorized Official Telephone | 4696626729 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 224Z00000X | Occupational Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225XM0800X |
Occupational Therapist Specialization: Mental Health |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225XN1300X |
Occupational Therapist Specialization: Neurorehabilitation |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225XP0019X |
Occupational Therapist Specialization: Physical Rehabilitation |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477098473 | Youthcentrix Therapy Services | Occupational Therapy Assistant | 11630 Helenoak Dr, Black Jack, MO 63033-7226 | 2016-12-29 |
| Street Address |
12 SAFFRIN HILL CT |
| City | GLEN CARBON |
| State | IL |
| Zip Code | 62034-1561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700025475 | Pamela Long | Occupational Therapist | 12 Saffrin Hill Ct, Glen Carbon, IL 62034-1561 | 2009-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740787795 | Kaleena Galletta | Nurse Practitioner | 4273 S., Il - 159, Glen Carbon, IL 62034 | 2018-04-06 |
| 1871092502 | Andrea Lee Sullivan | Dentist | 3024 South Il-159, Glen Carbon, IL 62034 | 2018-02-08 |
| 1417464918 | Stages Health & Wellness, LLC | Nurse Practitioner | 14 Crabapple Lane, Glen Carbon, IL 62034 | 2018-01-05 |
| 1700300498 | Michael Jay Arnold | Dentist | 3024 Il-159, Glen Carbon, IL 62034 | 2017-08-03 |
| 1679024228 | 360 Body Wellness Inc | Internal Medicine | 3407 Il State Route 157, Glen Carbon, IL 62034 | 2016-10-19 |
| 1346621505 | Stephanie N Lorts | Pediatrics | 4804 South State Route 159, Glen Carbon, IL 62034 | 2015-06-13 |
| 1205110111 | James Allan Staley | Pharmacist | #2 Cottonwood Rd, Glen Carbon, IL 62034 | 2011-10-11 |
| 1215224357 | Angela Eleni Kioultzopoulos | Speech-Language Pathologist | 7a Ginger Creek Village Dr., Glen Carbon, IL 62034 | 2011-07-08 |
| 1922320795 | Meridian Village Association | Skilled Nursing Facility | 27 Auerbach Place, Glen Carbon, IL 62034 | 2010-02-22 |
| 1679728356 | Erin Kathleen Immken | Counselor | 98 Junction Drive West, Suite 6, Glen Carbon, IL 62034 | 2008-11-24 |
| Find all providers in zip 62034 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154970721 | Kyle John Blievernicht | Occupational Therapist | 4955 S State Route 159 Ste B, Glen Carbon, IL 62034-1907 | 2019-09-06 |
| 1356749576 | Ashley Welmon | Occupational Therapist | 7 Ginger Creek Vlg, Glen Carbon, IL 62034-3517 | 2014-12-22 |
| 1700025475 | Pamela Long | Occupational Therapist | 12 Saffrin Hill Ct, Glen Carbon, IL 62034-1561 | 2009-02-19 |
| 1861534521 | Terri Nolan | Occupational Therapist | 12 Cover Bridge Lane, Glen Carbon, IL 62034 | 2007-02-12 |
| 1639786247 | Marlo Ann Stuart | Occupational Therapist | 400 S Station Rd, Glen Carbon, IL 62034-2743 | 2020-09-28 |
| 1780966770 | Tziona Rae Zeffren | Occupational Therapist | 4 Country Club Executive Park, Glen Carbon, IL 62034-1702 | 2011-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144691 | Jessica Kubinski | Occupational Therapist | 1051 W, Us-6, Morris, IL 60450 | 2020-11-03 |
| 1083214019 | Kelly Shavonne Johnson-means | Occupational Therapist | 715 N Sawyer Ave, Chicago, IL 60624-1532 | 2020-10-28 |
| 1912506247 | Elizabeth L Hadhazy | Occupational Therapist | 5 W Boulder Ct Apt A, Palos Hills, IL 60465-2347 | 2020-10-19 |
| 1952909343 | Samantha E Grimm | Occupational Therapist | 1651 Amaryllis Dr, Romeoville, IL 60446-5131 | 2020-10-16 |
| 1467050708 | Dpt Holdings LLC | Occupational Therapist | 417 E Il Route 173 Unit 101, Antioch, IL 60002-9407 | 2020-10-09 |
| 1245837129 | Lisa Marie Park | Occupational Therapist | 4960 W Argyle St Apt 2, Chicago, IL 60630-4888 | 2020-10-05 |
| 1154928141 | Raymund Espiritu | Occupational Therapist | 559 W Millers Rd, Des Plaines, IL 60016-2674 | 2020-10-03 |
| 1720695158 | Christine Baumann | Occupational Therapist | 9421 Burlington Ave Apt 1n, Brookfield, IL 60513-1868 | 2020-09-29 |
| 1972119279 | Caitlin Wend | Occupational Therapist | 2317 E Lincoln Highway, Suite B, Sterling, IL 61081 | 2020-09-22 |
| 1518573260 | Kaila Ann Lange | Occupational Therapist | 4450 48th St Ct, Rock Island, IL 61202 | 2020-09-18 |
| Find all providers with the same taxonomy | ||||
| City | GLEN CARBON |
| Zip Code | 62034 |
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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.