Active NPI
Jennifer Licata, O.T.
- Developmental Therapist
- West Palm Beach, FL
National Provider Identifier
1942488960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- OT10827
- Practice address
- 6242 Hammock Park Rd
West Palm Beach, FL 33411-6456 - Phone
- (561) 640-2920
- NPI assigned
- Jan 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT10827 | FL | |
| Developmental Therapist | 222Q00000X | OT10827 | FL | Primary |
Addresses
Primary practice location
6242 Hammock Park Rd
West Palm Beach, FL 33411-6456
Mailing address
6242 Hammock Park Rd
West Palm Beach, FL 33411-6456
Phone (561) 640-2920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT10827 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1942488960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6242 HAMMOCK PARK RD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334116456",
"telephone_number": "561-640-2920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6242 HAMMOCK PARK RD",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334116456",
"telephone_number": "561-640-2920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICATA",
"first_name": "JENNIFER",
"name_prefix": "Mrs.",
"credential": "O.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-31",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT10827",
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "FL",
"license": "OT10827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.