Provider Demographics
NPI:1619062031
Name:SPEECH AND LANGUAGE SERVICES OF THE TREASURE COAST, INC
Entity Type:Organization
Organization Name:SPEECH AND LANGUAGE SERVICES OF THE TREASURE COAST, INC
Other - Org Name:WHOLE CHILD THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANG PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-489-1714
Mailing Address - Street 1:2120 SE HERRON AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5853
Mailing Address - Country:US
Mailing Address - Phone:772-489-1714
Mailing Address - Fax:866-284-6714
Practice Address - Street 1:1607 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-9600
Practice Address - Country:US
Practice Address - Phone:772-291-1614
Practice Address - Fax:866-284-6714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014860700Medicaid
FL1215224969Medicaid
FL1619294006Medicaid
FL014860700Medicaid
FL23783000Medicaid
FL882751600Medicaid