Healthcare Provider Details

I. General information

NPI: 1598447104
Provider Name (Legal Business Name): NEUROLOGIC MUSIC THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 LYONS RD APT 24102
COCONUT CREEK FL
33063-6730
US

IV. Provider business mailing address

841 LYONS RD APT 24102
COCONUT CREEK FL
33063-6730
US

V. Phone/Fax

Practice location:
  • Phone: 754-400-0585
  • Fax: 954-953-2833
Mailing address:
  • Phone: 754-400-0585
  • Fax: 954-953-2833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name: TRENTON D BARRICK
Title or Position: EXECUTIVE DIRECTOR
Credential: MT-BC
Phone: 754-400-0585