Healthcare Provider Details

I. General information

NPI: 1578524278
Provider Name (Legal Business Name): CENTER FOR PEDIATRIC THERAPIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 DEER RUN ROAD
DANVILLE VA
24540
US

IV. Provider business mailing address

2140 FRANKLIN TURNPIKE
DANVILLE VA
24540
US

V. Phone/Fax

Practice location:
  • Phone: 434-797-5531
  • Fax: 434-797-5529
Mailing address:
  • Phone: 434-836-4158
  • Fax: 434-836-0250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN HOUSER BARKER
Title or Position: EXECUTIVE DIRECTOR
Credential: OTRIL
Phone: 434-797-5531