Basic Information
| Provider Information | |||||||||
| NPI: | 1972564409 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHILDREN'S THERAPY SOLUTIONS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3823 E STATE ROAD 64 | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342089041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417455111 | ||||||||
| FaxNumber: | 9417455667 | ||||||||
| Practice Location | |||||||||
| Address1: | 3823 E STATE ROAD 64 | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342089041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417455111 | ||||||||
| FaxNumber: | 9417455667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2006 | ||||||||
| LastUpdateDate: | 06/30/2021 | ||||||||
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| AuthorizedOfficialLastName: | THORESEN | ||||||||
| AuthorizedOfficialFirstName: | LENA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CO-OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9417455111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | OTR/L | ||||||||
| NPICertificationDate: | 06/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 261QM0801X | N | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | 101YP2500X | MH 8076 | FL | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional | 225100000X | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225X00000X | OT 9305 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 889422100 | 05 | FL | MEDICAID |