Provider Demographics
NPI:1790742880
Name:CHILDREN'S THERAPY SPECIALISTS, INC.
Entity Type:Organization
Organization Name:CHILDREN'S THERAPY SPECIALISTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DENNEHY-JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:843-222-0564
Mailing Address - Street 1:5069 SPANISH OAKS CT
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-5448
Mailing Address - Country:US
Mailing Address - Phone:843-357-6797
Mailing Address - Fax:843-357-6935
Practice Address - Street 1:5069 SPANISH OAKS CT
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5448
Practice Address - Country:US
Practice Address - Phone:843-357-6797
Practice Address - Fax:843-357-6935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34952251P0200X
MA107302251P0200X
225200000X
SC1784225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4158Medicaid