Collaborative Corner

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

COLLABORATIVE CORNER

Practice address

16550 Morningside Dr
Montverde, FL 34756-3231

Phone

(321) 231-4856

NPI assigned

Sep 24, 2020

Last updated

Sep 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Barisano

Title

Board of Directors

Phone

(321) 231-4856

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600905600000",
    "number": "1689281644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16550 MORNINGSIDE DR",
            "city": "MONTVERDE",
            "state": "FL",
            "postal_code": "347563231",
            "telephone_number": "321-231-4856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16550 MORNINGSIDE DR",
            "city": "MONTVERDE",
            "state": "FL",
            "postal_code": "347563231",
            "telephone_number": "321-231-4856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLABORATIVE CORNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A",
        "authorized_official_last_name": "BARISANO",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "321-231-4856"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.