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General NPI Number Information
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NPI Number | 1912792862
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Entity Type | Organization
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Legal Business Name | CONNECTION - TRANSDISCIPLINARY THERAPEUTIC SUPPORT CENTER, LLC
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1191 E NEWPORT CENTER DR STE 103
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-7736
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Country | US
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Telephone | 954-644-0682
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Fax | 754-333-4768
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Provider Business Mailing Address
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Address Line | 1191 E NEWPORT CENTER DR STE 103
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City | DEERFIELD BEACH
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State | FL
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Zip | 33442-7736
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Country | US
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Telephone | 954-644-0682
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Fax | 754-333-4768
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Authorized Official
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Title or Position | MANAGER / OWNER
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Name | MR. ANDRE DE PAIVA COELHO SOPHIA
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Credential |
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Telephone | 954-253-6455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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