Proclaim Communication and Rehabilitation Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PROCLAIM COMMUNICATION AND REHABILITATION SERVICES, LLC

Practice address

4680 Lipscomb St NE Ste 4
Palm Bay, FL 32905-2984

Phone

(321) 209-0171

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Shavonne Mariscal, MS CCC-SLPNPI 1174161681

Title

Owner/Manager

Phone

(321) 209-0171

Specialties & licenses 1

Addresses

Other names 4

• Proclaim Rehabilitation Services LLC Former legal business name
• Proclaim Communication and Rehabilitation Services Other name
• Proclaim Communication and Rehabilitation Services, LLC Other name
• Proclaim Services Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shavonne Mariscal

  • Speech-Language Pathologist
  • Palm Bay, FL
  • NPI 1174161681
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1952069882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 GUINEVERE DR",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329086431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4680 LIPSCOMB ST NE STE 4",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052984",
            "telephone_number": "321-209-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCLAIM COMMUNICATION AND REHABILITATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "MARISCAL",
        "authorized_official_first_name": "SHAVONNE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "321-209-0171",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proclaim Rehabilitation Services LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Proclaim Communication and Rehabilitation Services",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Proclaim Communication and Rehabilitation Services, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Proclaim Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Speech-Language Pathologist in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.