Philips Autism Therapy Center Inc

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PHILIPS AUTISM THERAPY CENTER INC

Practice address

2075 Meadowlane Ave
W. Melbourne, FL 32904

Phone

(888) 554-6558

Fax

(321) 757-5177

NPI assigned

Jul 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Frank P Decaro, PH.D

Title

Owner/Ceo

Phone

(321) 432-9418

Specialties & licenses 4

Addresses

Other names 1

• Philip's Autism Therapy Center Doing business as

Locations

Practitioners 1

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

• Kimberly Ann Bray, BCBA

  • Behavior Analyst
  • West Melbourne, FL
  • NPI 1699929547
  NPD (past)

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1992961973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 N WICKHAM RD",
            "address_2": "SUITE 12-309",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407976",
            "telephone_number": "888-554-6558",
            "fax_number": "321-757-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 MEADOWLANE AVE",
            "city": "W. MELBOURNE",
            "state": "FL",
            "postal_code": "32904",
            "telephone_number": "888-554-6558",
            "fax_number": "321-757-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIPS AUTISM THERAPY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-30",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "DECARO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "321-432-9418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "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": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Philip's Autism Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Lynn Nickens, M.S, LMHC
• Norpro Prosthetics and Orthotics, Inc.
• Alia Payne
• Lennie Grace Pence, LMT
• Donna Petersen
• Robin Prater
• Johnnie L Puccio, PTA, LMT
• Brian P Reilly, M.S., CCC-SLP
• Dixie D. Riepl
• Maria Victoria Rodriguez I

• Speech-Language Pathologist in W. Melbourne, FL
• Providers in W. Melbourne, 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 Feb 18, 2009; 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.