Healthcare Provider Details

I. General information

NPI: 1407129430
Provider Name (Legal Business Name): TICKTALK THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 04/06/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 SAINT ROSE PKWY STE 110
HENDERSON NV
89052-4842
US

IV. Provider business mailing address

2875 SAINT ROSE PKWY STE 110
HENDERSON NV
89052-4842
US

V. Phone/Fax

Practice location:
  • Phone: 800-966-0535
  • Fax: 800-966-1135
Mailing address:
  • Phone: 800-966-0535
  • Fax: 800-966-1135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MS. SVETLANA FEDYUSHKINA
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 800-966-0535