MEDICARE: CREATIVE THERAPY SOLUTIONS 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	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist	SA6347	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811261928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATIVE THERAPY SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	2168 JOG RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-6015
Country	:	US
Telephone Number	:	561-641-5757
Fax Number	:	561-641-7373

Provider Business Practice Location Address
First Line	:	2168 JOG RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-6015
Country	:	US
Telephone Number	:	561-641-5757
Fax Number	:	561-641-7373

Authorized Official
Title or Position	:	DIRECTOR/SPEECH LANGUAGE PATHOLOGIS
Name	:	DR. ELLEN F MATTINGLY
Credential	:	SLP.D., CCC-SLP
Telephone Number	:	561-641-5757

Provider Enumeration Date	:	03/07/2012
Last Update Date	:	01/18/2024

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Directions to “CREATIVE THERAPY SOLUTIONS LLC ” Practice Location

Language	Start Address	Practice Location

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