North Star Pediatric Therapy

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

NORTH STAR PEDIATRIC THERAPY

Practice address

2120 E Park View LN
Phoenix, AZ 85024-5302

Phone

(602) 402-3127

NPI assigned

Jul 24, 2026

Organization subpart

No

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

Authorized official

Name

Justin David Lackey, OTD, OTR/L

Title

Ceo

Phone

(602) 402-3127

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1922929918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 E PARK VIEW LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850245302",
            "telephone_number": "602-402-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E PARK VIEW LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850245302",
            "telephone_number": "602-402-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STAR PEDIATRIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "LACKEY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-402-3127",
        "authorized_official_credential": "OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.