NPIMap

Organization Active NPI

Providence Academy, Inc

Doing business as Providence Foundation

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1972878437
Registry record updated Jan 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PROVIDENCE ACADEMY, INC
Doing business as
Providence Foundation
Practice address
1561 S Alafaya TRL
Suite 200
Orlando, FL 32828-8956
Phone
(407) 382-5551
Fax
(407) 382-5637
NPI assigned
Mar 16, 2012
Last updated
Jan 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2013

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

Authorized official

Name
Mrs. Alicia Naret Braccia, MA,CAS,ABSNP, LSPNPI 1609008317
Title
Foundation President
Phone
(407) 382-5551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1561 S Alafaya TRL
Suite 200
Orlando, FL 32828-8956

Mailing address

1561 S Alafaya TRL
Suite 200
Orlando, FL 32828-8956
Phone (407) 382-5551

Other names 1

  • Providence Foundation Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1972878437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 S ALAFAYA TRL",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288956",
            "telephone_number": "407-382-5551",
            "fax_number": "407-382-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 S ALAFAYA TRL",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328288956",
            "telephone_number": "407-382-5551",
            "fax_number": "407-382-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE ACADEMY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-16",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "BRACCIA",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "NARET",
        "authorized_official_title_or_position": "FOUNDATION PRESIDENT",
        "authorized_official_telephone_number": "407-382-5551",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA,CAS,ABSNP, LSP"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.