Childhood Development Specialists, PLLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

R4588 Issued in KY

Legal business name

CHILDHOOD DEVELOPMENT SPECIALISTS, PLLC

Practice address

401 Berger Farm Dr
Mount Washington, KY 40047-5400

Phone

(502) 507-3841

NPI assigned

Sep 26, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Penland, OTR/L

Title

Ceo

Phone

(502) 507-3841

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1443225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443225600000",
    "number": "1831569367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BERGER FARM DR",
            "city": "MOUNT WASHINGTON",
            "state": "KY",
            "postal_code": "400475400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BERGER FARM DR",
            "city": "MOUNT WASHINGTON",
            "state": "KY",
            "postal_code": "400475400",
            "telephone_number": "502-507-3841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDHOOD DEVELOPMENT SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-26",
        "last_updated": "2015-09-26",
        "status": "A",
        "authorized_official_last_name": "PENLAND",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-507-3841",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "KY",
            "license": "R4588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Early Intervention Provider Agency in Mount Washington, KY
• Providers in Mount Washington, KY by specialty
• Early Intervention Provider Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2015; 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.