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NPI Code Detail

MEDICARE: PROGRESSUS THERAPY, LLC

MEDICARE: PROGRESSUS 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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker
3106E00000XAssistant Behavior Analyst
4106H00000XMarriage & Family Therapist
5106S00000XBehavior Technician
6225100000XPhysical Therapist
7225X00000XOccupational Therapist
8235Z00000XSpeech-Language Pathologist
9103K00000XBehavior Analyst

General Provider Information

NPI Number : 1396050894
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROGRESSUS THERAPY, LLC
Provider Business Mailing Address
First Line : PO BOX 631278
Second Line :
City : CINCINNATI
State : OH
Zip : 45263-1278
Country : US
Telephone Number : 800-356-4049
Fax Number : 847-584-2604
Provider Business Practice Location Address
First Line : 2574 COMMERCE PKWY
Second Line :
City : NORTH PORT
State : FL
Zip : 34289-9334
Country : US
Telephone Number : 800-356-4049
Fax Number : 847-584-2604
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : JULIE BUSH
Credential :
Telephone Number : 847-584-2604
Provider Enumeration Date : 08/10/2010
Last Update Date : 09/14/2022

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Directions to “PROGRESSUS THERAPY, LLC ” Practice Location

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