Provider Demographics
NPI:1033444013
Name:MS. COURTNEY'S THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:MS. COURTNEY'S THERAPY SERVICES, LLC
Other - Org Name:CONNECTIONS THERAPY 4 KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTR/L
Authorized Official - Phone:954-353-8777
Mailing Address - Street 1:2833 EXECUTIVE PARK DR
Mailing Address - Street 2:300
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3650
Mailing Address - Country:US
Mailing Address - Phone:954-353-8777
Mailing Address - Fax:954-389-1990
Practice Address - Street 1:2833 EXECUTIVE PARK DR
Practice Address - Street 2:#202
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3650
Practice Address - Country:US
Practice Address - Phone:954-353-8777
Practice Address - Fax:954-389-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 9973225XP0200X
FLOT 13120225XP0200X
FLOT 11230225XP0200X
FLOT 12777225XP0200X
FLSA 9092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001491200Medicaid