PHOENIX PEDIATRIC THERAPY SERVICES, LLC (NPI# 1558978932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558978932 |
| Entity Type | Organization |
| Organization Name | PHOENIX PEDIATRIC THERAPY SERVICES, LLC |
| Practice Address |
16201 Trade Zone Ave Ste 106 Upper Marlboro MD 20774-8758 |
| Mailing Address |
12806 Sholton St Upper Marlboro MD 20774-1715 |
| Practice Telephone | 2404258605 |
| Mailing Telephone | 2406205688 |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-09-29 |
| Authorized Official Name | MRS. TIFFANY B. PHOENIX (CEO/SPEECH-LANGUAGE PATHOLOGIST) |
| Authorized Official Telephone | 2404258605 |
| Authorized Official Credential | M.S.,CCC-SLP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| Street Address |
16201 TRADE ZONE AVE STE 106 |
| City | UPPER MARLBORO |
| State | MD |
| Zip Code | 20774-8758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922637156 | Marie Charlotte Teboutsou Tsodzou | Nurse Practitioner | 9317 Lavall Drive, Upper Marlboro, MD 20774 | 2020-04-08 |
| 1467093443 | Richland Support Services Corp. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11551 Joyceton Drive, Upper Marlboro, MD 20774 | 2019-10-01 |
| 1770134124 | Alan L Kahn | Counselor | 301 Largo Rd., Largo, MD 20774 | 2019-09-26 |
| 1619522034 | Francisca Ifeoma Alintah | Registered Nurse | 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 | 2019-08-02 |
| 1609337146 | Crystal Osuchukwu | Counselor | 1300 Mccormick Dr, Upper Marlboro, MD 20774 | 2019-03-27 |
| 1861968489 | Collaborative Concepts of Maryland | Counselor | 1400 Mercantile Lane, Suite 208, Largo, MD 20774 | 2018-10-22 |
| 1073097622 | Triple Angels Homecare Services, Inc. | In Home Supportive Care | 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 | 2018-09-19 |
| 1922589654 | Optimum Resource Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 | 2018-08-21 |
| 1811475254 | Kolawole Richard Olatunde | Home Health Aide | 11405 Villa Court, Upper Marlboro, MD 20774 | 2018-07-28 |
| 1548747769 | Tiara Williams | Counselor | 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 | 2018-07-20 |
| Find all providers in zip 20774 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598314593 | Jeanelle Leonce Kiarie | Speech-Language Pathologist | 12650 Brooke Ln, Upper Marlboro, MD 20772-9337 | 2019-09-11 |
| 1528611324 | Shrita Squire | Speech-Language Pathologist | 14308 Hampshire Hall Ct, Upper Marlboro, MD 20772-2955 | 2019-07-20 |
| 1750945465 | Lakeesha L Hammond | Speech-Language Pathologist | 1313 Merganser Ct, Upper Marlboro, MD 20774-7016 | 2019-04-29 |
| 1689238768 | Speech-language Swallowing Specialist, LLC | Speech-Language Pathologist | 5209 Chestnut Manor Ct, Upper Marlboro, MD 20772-3175 | 2019-04-24 |
| 1821561051 | Heather Kafele | Speech-Language Pathologist | 11440 Dunloring Pl, Upper Marlboro, MD 20774-5752 | 2019-01-10 |
| 1023581998 | Marcella Coleman | Speech-Language Pathologist | 11454 Dunloring Pl, Upper Marlboro, MD 20774-5776 | 2019-01-03 |
| 1114498938 | Kathleen Wyvill Edelen | Speech-Language Pathologist | 7100 Croom Station Rd, Upper Marlboro, MD 20772-9657 | 2018-12-06 |
| 1982173175 | Caryl Denise King Grant | Speech-Language Pathologist | 501 Watkins Park Dr, Upper Marlboro, MD 20774-8801 | 2018-11-16 |
| 1013419340 | The Final Piece Speech and Language Therapy, LLC | Speech-Language Pathologist | 3716 Chancelsors Dr, Upper Marlboro, MD 20772-8246 | 2018-03-02 |
| 1104209816 | Building Bridges Therapies, LLC | Speech-Language Pathologist | 8539 Grandhaven Ave, Upper Marlboro, MD 20772-5070 | 2015-06-30 |
| Find all providers in UPPER MARLBORO | ||||
| City | UPPER MARLBORO |
| Zip Code | 20774 |
Please comment or provide details below to improve the information on PHOENIX PEDIATRIC THERAPY SERVICES, 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.