NPIMap

Organization Active NPI

Support Therapy Group LLC

  • Clinic/Center
  • Lakeland, FL
National Provider Identifier
1578282059
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SUPPORT THERAPY GROUP LLC
Practice address
3240 Airfield Dr E Ste 202
Suite 202
Lakeland, FL 33811-1247
Phone
(646) 966-2583
Fax
(407) 386-6505
NPI assigned
Aug 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Authorized official

Name
Ismery D Morales Martinez, SLP/BCBANPI 1174032031
Title
Manager
Phone
(407) 486-3297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinic/Center 261Q00000X Primary
Hearing and Speech Clinic/Center 261QH0700X

Addresses

Primary practice location

3240 Airfield Dr E Ste 202
Suite 202
Lakeland, FL 33811-1247

Mailing address

3240 Airfield Dr E Ste 202
Lakeland, FL 33811-1247
Phone (646) 966-2583

National Provider Directory

National Provider Directory

Locations

3240 Airfield Dr E
Ste 202
Lakeland, FL 33811
Phone (646) 966-2583

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1578282059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 AIRFIELD DR E STE 202",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111247",
            "telephone_number": "646-966-2583",
            "fax_number": "407-386-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 AIRFIELD DR E STE 202",
            "address_2": "SUITE 202",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338111247",
            "telephone_number": "646-966-2583",
            "fax_number": "407-386-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORT THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "MORALES MARTINEZ",
        "authorized_official_first_name": "ISMERY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-486-3297",
        "authorized_official_credential": "SLP/BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.