Healthcare Provider Details

I. General information

NPI: 1962212019
Provider Name (Legal Business Name): LAUNCH COMMUNICATION THERAPY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 ORANGE ST
ST AUGUSTINE FL
32084-3633
US

IV. Provider business mailing address

155 BARTRAM MARKET DR STE 135
ST JOHNS FL
32259-4583
US

V. Phone/Fax

Practice location:
  • Phone: 904-547-7500
  • Fax:
Mailing address:
  • Phone: 904-815-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA GODSEY
Title or Position: OWNER
Credential: M.S., CCC-SLP
Phone: 904-815-5200