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).
| 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 |
| 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 |
| Street Address |
6659 CRAFTSMAN SQUARE DR NE |
| City | ROCKFORD |
| State | MI |
| Zip Code | 49341-8861 |
| 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 Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| 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] |
| 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 | ||||
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| 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.