THERAPIST DIRECT INCORPORATED (NPI# 1306985072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306985072 |
| Entity Type | Organization |
| Organization Name | THERAPIST DIRECT INCORPORATED |
| Practice Address |
260 Bentley Place Way Covington GA 30016-1106 |
| Practice Telephone | 4047562600 |
| Practice Fax Number | 4047562524 |
| Mailing Telephone | 4047562600 |
| Mailing Fax Number | 4047562524 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SABRENIA RENEE ROBERTS (SPEECH LANGUAGE PATHOLOGIST) |
| Authorized Official Telephone | 6787254628 |
| Authorized Official Credential | MA, CCC, SLP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
SLPA000040 | GA | Speech, Language and Hearing Service Providers |
| X | 235Z00000X | Speech-Language Pathologist | SLP004287 | GA | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 10046954 | 05 | |
| GA | 347237 | 05 |
| Street Address |
260 BENTLEY PLACE WAY |
| City | COVINGTON |
| State | GA |
| Zip Code | 30016-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013565605 | Katrina Williams | Case Manager/Care Coordinator | 220 Meadowidge Dr, Covington, GA 30016 | 2019-08-28 |
| 1407322134 | Mali Rice | Registered Nurse | 105 Syracuse Lane, Covington, GA 30016 | 2018-10-20 |
| 1619452927 | Angelina Jones | Contractor | 290 Piedmont Circle, Covington, GA 30016 | 2018-10-02 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1922538529 | Tisha Owes | Home Health | 110 Trinity Dr, Covington, GA 30016 | 2017-06-15 |
| 1053868695 | Delhia Assanah IIi | Counselor | 101 Kirkland Road, Covington, GA 30016 | 2016-09-01 |
| 1760834295 | Resurgens East Surgery Center, LLC | Clinic/Center | 3241 Iris Dr, Suite 100, Covington, GA 30016 | 2016-07-08 |
| 1528443371 | Latoya N Wright | Counselor | 100 Winnstead Place, Covington, GA 30016 | 2015-07-22 |
| 1598157307 | Sierra Private Homecare, Inc. | Adult Companion | 75 Cinnamon Oak Circle, Covington, GA 30016 | 2015-03-03 |
| 1326391079 | Lana Abiola Fraser | Nurse's Aide | 840 Oakhill Road, Covington, GA 30016 | 2012-10-18 |
| Find all providers in zip 30016 | ||||
| Taxonomy Code | 2355S0801X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Speech-Language Assistant |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619323409 | La Toya Glenn | Specialist/Technologist | 130 Pebble Ridge Dr, Covington, GA 30014-8452 | 2016-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760036156 | Candace L Hughes | Specialist/Technologist | 1058 5th Ave, Jonesboro, GA 30236-3299 | 2019-07-24 |
| 1043864432 | Destiny Lacara Mack | Specialist/Technologist | 160 Roberts Dr, Riverdale, GA 30274-3302 | 2019-07-24 |
| 1437710753 | Kristyn Spelina | Specialist/Technologist | 2775 Cruse Rd Ste 2002, Lawrenceville, GA 30044-7147 | 2019-06-26 |
| 1073083564 | Kimberly Odom | Specialist/Technologist | 2602 White Rose Dr, Loganville, GA 30052-2196 | 2018-11-28 |
| 1811416498 | Susan M Kirkland | Specialist/Technologist | 165 Jackson Dr, Resaca, GA 30735 | 2017-09-14 |
| 1558737775 | Diane Armstead | Specialist/Technologist | 809 Muirfield Trl, Marietta, GA 30068-2653 | 2015-08-12 |
| 1982025979 | Lm Speech | Specialist/Technologist | 2547 Ridgewood Ter Nw, Atlanta, GA 30318-1320 | 2013-12-18 |
| 1497090898 | Tiara Lynn | Specialist/Technologist | 3180 Blackfoot Ln, Rex, GA 30273-1065 | 2012-12-11 |
| 1467724351 | Bianca C Kelly | Specialist/Technologist | 3209 Saint Clair Dr Ne, Atlanta, GA 30329-2662 | 2012-02-07 |
| 1528349156 | Genesis Healthcare Systems LLC | Specialist/Technologist | 1885 Leland Drive, Marietta, GA 30067 | 2011-09-09 |
| Find all providers with the same taxonomy | ||||
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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.