2911 Therapy, LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

2911 THERAPY, LLC

Doing business as

2911 Therapy, LLC

Practice address

300 S Pine Island Rd Ste 214
Plantation, FL 33324-2620

Phone

(754) 238-6079

NPI assigned

Mar 17, 2022

Last updated

Mar 17, 2022By 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

Mrs. Renyale Treon Davis, LCSWNPI 1376606921

Title

Owner/Clinician

Phone

(754) 238-6079

Specialties & licenses 1

Addresses

Other names 1

• 2911 Therapy, LLC Doing business as

Electronic endpoints 1

Locations

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.

• Renyale Treon Davis, LCSW

  • Clinical Social Worker
  • Tamarac, FL
  • NPI 1376606921
  NPD Authorized official

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1821746827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 W OAKLAND PARK BLVD UNIT 190636",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333198725",
            "telephone_number": "754-238-6079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S PINE ISLAND RD STE 214",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242620",
            "telephone_number": "754-238-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2911 THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RENYALE",
        "authorized_official_middle_name": "TREON",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "754-238-6079",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://2911therapy.secure-client-area.com",
            "affiliation": "N",
            "endpointDescription": "Secure Portal",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Client EHR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Client Documents, Video Sessions, Billing",
            "address_1": "300 S Pine Island Rd Ste 214",
            "city": "Plantation",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333242620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "2911 Therapy, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Point of Service in Plantation, FL
• Providers in Plantation, FL by specialty
• Point of Service in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.