Provider Demographics
NPI:1740495191
Name:ASPIRE PEDIATRIC THERAPY, LLC
Entity type:Organization
Organization Name:ASPIRE PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:412-474-3566
Mailing Address - Street 1:993 BRODHEAD ROAD
Mailing Address - Street 2:STE 10
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-2331
Mailing Address - Country:US
Mailing Address - Phone:412-474-3566
Mailing Address - Fax:412-474-3575
Practice Address - Street 1:993 BRODHEAD ROAD
Practice Address - Street 2:STE 10
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2331
Practice Address - Country:US
Practice Address - Phone:412-474-3566
Practice Address - Fax:412-474-3575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005312L225X00000X
PA225X00000X, 235Z00000X
PASL006468235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1553259OtherGATEWAY GROUP
PA7257673OtherAETNA OT
PA001852889OtherSLP HIGHMARK
PA001852888OtherHIGHMARK OT GROUP
PA1016605640003Medicaid
PA1016605640002Medicaid
PA1016605640001Medicaid
PA7257673OtherAETNA OT
PA1016605640001Medicaid
PA1016605640002Medicaid