MITTEN STATE PEDIATRIC THERAPY LLC


Address: 6659 Craftsman Square Dr Ne, Rockford, MI 49341-8861
Phone: 2485354666

MITTEN STATE PEDIATRIC THERAPY LLC (NPI# 1063021715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063021715
Entity Type Organization
Organization Name MITTEN STATE PEDIATRIC THERAPY LLC
Practice Address 6659 Craftsman Square Dr Ne
Rockford
MI 49341-8861
Practice Telephone 2485354666
Mailing Telephone 2485354666
Enumeration Date 2020-07-29
Last Update Date 2020-07-29
Authorized Official Name LINDSAY COURSEN (OCCUPATIONAL THERAPIST)
Authorized Official Telephone 2485354666
Authorized Official Credential OTRL
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 235Z00000X Speech-Language Pathologist Speech, Language and Hearing Service Providers
N 225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Y 225X00000X Occupational Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 6659 CRAFTSMAN SQUARE DR NE
City ROCKFORD
State MI
Zip Code 49341-8861

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801451836 Heather Nash Social Worker 65 S. Main Street, Lower Level, Rockford, MI 49341 2019-05-06
1366967069 Caitlin Lebron Case Manager/Care Coordinator 8625 Wildcat Run Dr Ne, Rockford, MI 49341 2017-08-03
1366967077 Elite Nurse Staffing, LLC Nursing Care 3836 Windwood Drive, Ne, Rockford, MI 49341 2017-08-03
1336678747 Melissa Diane Maynard Behavior Technician 3361 36th St., Grand Rapids, MI 49341 2017-06-08
1376077453 Spectrum Health Primary Care Partners Internal Medicine 8501 Meadowcreek Dr, Rockford, MI 49341 2017-04-17
1871025254 Robin D Dine Behavior Technician 8636 Shaner Ave, Rockford, MI 49341 2017-04-03
1528503216 Miles Skalnek Pharmacist 511 10 Mile Road, Rockford, MI 49341 2017-01-04
1366801664 Lorri Ann Kelbel Massage Therapist 11591 Northland Drive Ne, Rockford, MI 49341 2016-02-15
1275872046 Eugene Louis Bonofiglo Dentist 4655- 14 Mile Rd Ne, Rockford, MI 49341 2013-02-13
1740539246 Erica Joyce Nichols Chiropractor 6769 Courtland Dr, Suite 100, Rockford, MI 49341 2012-08-30
Find all providers in zip 49341

Taxonomy Information

Taxonomy Code 225X00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Occupational Therapist

Taxonomy Definition

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134654031 Kiley Wallden Occupational Therapist 4617 White Oak Ave, Rockford, IL 61114-6235 2017-04-27
1831644749 Tessa Lee Occupational Therapist 3422 Lauderdale Ln, Rockford, IL 61107 2016-08-20
1043672611 Ann Licari Occupational Therapist 4123 Singleton Rd, Rockford, IL 61114-6159 2016-03-23
1497142616 Adrienne Samuel Occupational Therapist 2123 Clinton St, Rockford, IL 61103-4104 2015-04-26
1417394099 Jensine Houghton Occupational Therapist 4010 Woodhill Ct, Rockford, MN 55373-9105 2013-05-23
1194048041 Nita Patel Occupational Therapist 960 Tulip Ln Apt 4, Rockford, IL 61107-5738 2010-03-07
1336377993 Colleen Mary Mcdonald Occupational Therapist 417 N Rockford Ave, Rockford, IL 61107-4548 2009-06-23
1831368463 Jennifer Papoccia Occupational Therapist 1411 E Gate Pkwy, Rockford, IL 61108-6140 2008-02-28
1124297759 Letitia Taylor Occupational Therapist 3250 Brook Harbour Dr, Rockford, IL 61114-6650 2008-02-28
1639375728 Ellen M Marqua Occupational Therapist 3108 Rural St, Rockford, IL 61107-3461 2007-06-25
Find all providers in ROCKFORD

Competitor

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City ROCKFORD
Zip Code 49341

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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