Mack Occupational Therapy, LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

3730 Issued in SC

Legal business name

MACK OCCUPATIONAL THERAPY, LLC

Practice address

1213 Llewellyn Rd
Mount Pleasant, SC 29464-3816

Phone

(336) 817-4278

NPI assigned

Jun 14, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Maria Gonzales Mack, MS OTR/LNPI 1114237823

Title

Occupational Therapist

Phone

(336) 817-4278

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maria Mack, OTR/L

  • Pediatric Occupational Therapist
  • Mount Pleasant, SC
  • NPI 1114237823

  Pediatrics

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1063774107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 LLEWELLYN RD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 LLEWELLYN RD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643816",
            "telephone_number": "336-817-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK OCCUPATIONAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "GONZALES",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "336-817-4278",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "SC",
            "license": "3730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Macbride
• Abigail Macdonald
• Willaim D Macdonald, DMD
• Allen Kent Maceachern, LMFT
• Kristen Machado, MA, LPC
• Maria Mack, OTR/L
• Molly Lawton Mackenzie, LPC, NCC
• Kathryn Maday, LISW-CP/AP
• Lauren Edewaard Madden, LPC-A
• Made 2 Move Physical Therapy of Mount Pleasant, LLC

• Pediatric Occupational Therapist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Pediatric Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.