NPIMap

Organization Active NPI

Hope Harbor Therapies

  • Speech-Language Pathologist
  • Daytona Beach, FL
National Provider Identifier
1649622358
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
HOPE HARBOR THERAPIES
Doing business as
Hope Harbor Therapies
Practice address
210 S Beach St Ste 200
Daytona Beach, FL 32114-4433
Phone
(386) 898-6040
Fax
(386) 256-2320
NPI assigned
Jul 6, 2016
Last updated
Sep 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Maika Fernandez-Wallace
Title
Program Director
Phone
(386) 898-6040

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X NU
Pediatric Occupational Therapist 225XP0200X NU
Speech-Language Pathologist 235Z00000X NU Primary
Case Management Agency 251B00000X NU
Clinic/Center 261Q00000X NU
Behavior Analyst 103K00000X NU
Feeding, Eating & Swallowing Occupational Therapist 225XF0002X NU
Developmental Therapist 222Q00000X NU

Addresses

Primary practice location

210 S Beach St Ste 200
Daytona Beach, FL 32114-4433

Mailing address

210 S Beach St Ste 200
Daytona Beach, FL 32114-4433
Phone (386) 898-6040

Other identifiers 2

IdentifierTypeStateIssuer
019647200MedicaidFL
019212700MedicaidFL

Other names 2

  • Hope Harbor Therapies Doing business as
  • Hope Group Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1649622358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S BEACH ST STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144433",
            "telephone_number": "386-898-6040",
            "fax_number": "386-256-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S BEACH ST STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144433",
            "telephone_number": "386-898-6040",
            "fax_number": "386-256-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE HARBOR THERAPIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ-WALLACE",
        "authorized_official_first_name": "MAIKA",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "386-898-6040"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225XF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Feeding, Eating & Swallowing",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019647200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019212700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hope Harbor Therapies",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hope Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.