MEDICARE: CONNECTED THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1295504777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTED THERAPY LLC

Provider Business Mailing Address
First Line	:	7901 4TH ST N STE 18101
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	954-288-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	11442 GARDEN CRESS TRL
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-4226
Country	:	US
Telephone Number	:	954-288-8914
Fax Number	:

Authorized Official
Title or Position	:	OWNER, SPEECH-LANGUAGE PATHOLOGIST
Name	:	JESSIE GINSBURG BARAK
Credential	:	MS CCC-SLP
Telephone Number	:	954-288-8914

Provider Enumeration Date	:	12/26/2023
Last Update Date	:	12/26/2023

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Directions to “CONNECTED THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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