Provider Demographics
NPI:1306409354
Name:ALL THERAPIES SUPPORT, INC
Entity Type:Organization
Organization Name:ALL THERAPIES SUPPORT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSSFORD-CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LMHC
Authorized Official - Phone:386-316-3004
Mailing Address - Street 1:23 RYBAR LN
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-6445
Mailing Address - Country:US
Mailing Address - Phone:386-316-3004
Mailing Address - Fax:
Practice Address - Street 1:23 RYBAR LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-6445
Practice Address - Country:US
Practice Address - Phone:386-316-3004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106672600Medicaid
FL019240300Medicaid
FL105642800Medicaid
FL017749900Medicaid
FL107539200Medicaid
FL108326300Medicaid
FL1760614713OtherNPI