IDD THERAPEUTIC SERVICES PLLC (NPI# 1881073757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881073757 |
| Entity Type | Organization |
| Organization Name | IDD THERAPEUTIC SERVICES PLLC |
| Practice Address |
2111 Spencer Ct La Grange KY 40031 |
| Mailing Address |
8206 Highview Ct Crestwood KY 40014-8105 |
| Practice Telephone | 5022622887 |
| Mailing Telephone | 5022622887 |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2018-05-15 |
| Authorized Official Name | JEFFREY HICKS (OWNER) |
| Authorized Official Telephone | 8552599183 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100393570 | 05 | |
| KY | 7100394720 | 05 |
| Street Address |
2111 SPENCER CT |
| City | LA GRANGE |
| State | KY |
| Zip Code | 40031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205940137 | Michelle T Ramsey | Physical Therapist | 2111 Spencer Ct, La Grange, KY 40031-6742 | 2006-08-18 |
| 1033583158 | Felicia Meyers | Counselor | 2111 Spencer Ct, La Grange, KY 40031-6742 | 2015-12-01 |
| 1639408230 | Lynda Denise Payne-stikes | Speech-Language Pathologist | 2111 Spencer Ct, La Grange, KY 40031-6742 | 2009-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723089 | Nancee L Berling | Registered Nurse | 1914 Miller Ln, La Grange, KY 40031 | 2018-06-06 |
| 1134643000 | Zachary Byrne | Dentist | 3108 S. Hwy 53, Lagrange, KY 40031 | 2017-08-01 |
| 1609399971 | Walgreen Co | Pharmacy | 408 Oldham Plaza, La Grange, KY 40031 | 2017-07-19 |
| 1447790886 | Carolyn Marie Burton | Speech-Language Pathologist | 4603 Timber Walk Ct., Lagrange, KY 40031 | 2017-03-05 |
| 1699145466 | Janet Frager | Nurse Practitioner | 1023 New Moody Ln Ste 101, La Grange, KY 40031 | 2015-10-05 |
| 1730559188 | Amanda Lynn Drawbaugh | Physical Therapist | Ascb Therapy, 4603 Timber Walk Ct., Lagrange, KY 40031 | 2015-09-29 |
| 1407250483 | Aaron Mangum | Specialist/Technologist | 2850 Jericho Road, Lagrange, KY 40031 | 2014-10-20 |
| 1073944500 | Tamara Thomas | Case Manager/Care Coordinator | 4121 Spencer Ct, Lagrange, KY 40031 | 2013-12-10 |
| 1669643854 | Alisa Marie Skinner | Physical Therapist | 618 Kentucky Ave, Lagrange, KY 40031 | 2008-03-17 |
| 1245410711 | Jennifer Lee Thomas | Nurse Practitioner | 1015 New Moody Lane, Lagrange, KY 40031 | 2007-11-13 |
| Find all providers in zip 40031 | ||||
| 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 |
|---|---|---|---|---|
| 1073985974 | Cynthia K Donner | Occupational Therapist | 1204 Cedar Springs Pkwy, La Grange, KY 40031-8037 | 2015-10-30 |
| 1164810982 | Stcy Grieshaber | Occupational Therapist | 1031 Shore Line Dr, La Grange, KY 40031-1385 | 2014-12-31 |
| 1467840348 | Veronica Olivares-garza | Occupational Therapist | 260 West Live Oak St, La Grange, TX 78945 | 2014-12-31 |
| 1598076655 | Stephanie Morse | Occupational Therapist | 229 S Brainard Ave, La Grange, IL 60525-2116 | 2010-06-23 |
| 1225172570 | Melinda Rose Fagan | Occupational Therapist | 1301 W Cossitt Ave, La Grange, IL 60525-2145 | 2007-02-19 |
| 1609481407 | Alison Miles | Occupational Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-09-09 |
| 1841823044 | Carissa Carpenter | Occupational Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2020-02-15 |
| 1831734540 | Jingfang Dong | Occupational Therapist | 339 9th Ave, La Grange, IL 60525-6429 | 2019-11-18 |
| 1174166490 | Morgan Profitt | Occupational Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2019-10-18 |
| 1770125429 | Hannah Daep | Occupational Therapist | 4603 Timberwalk Ct, La Grange, KY 40031-6746 | 2019-10-15 |
| Find all providers in LA GRANGE | ||||
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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.