Destiny Therapeutic Services LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

DESTINY THERAPEUTIC SERVICES LLC

Practice address

4186 Okeechobee Road
Suite 77
Fort Pierce, FL 34947

Phone

(772) 359-1267

Fax

(772) 264-8224

NPI assigned

Jul 28, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Laronda Chatman

Title

Owner

Phone

(772) 359-1267

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1982330353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4186 OKEECHOBEE ROAD",
            "address_2": "SUITE 77",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34947",
            "telephone_number": "772-359-1267",
            "fax_number": "772-264-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4186 OKEECHOBEE ROAD",
            "address_2": "SUITE 77",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34947",
            "telephone_number": "772-359-1267",
            "fax_number": "772-264-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "CHATMAN",
        "authorized_official_first_name": "LARONDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-359-1267",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111187900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fort Pierce, FL
• Providers in Fort Pierce, 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 Jul 28, 2022; 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.