Provider Demographics
NPI:1730552571
Name:CONSOLIDATED THERAPIES, LLC
Entity type:Organization
Organization Name:CONSOLIDATED THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:HUGGINS
Authorized Official - Last Name:MITIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,MS,CCC-A/SLP
Authorized Official - Phone:901-275-0896
Mailing Address - Street 1:5699 GETWELL RD
Mailing Address - Street 2:BUILDING H, SUITE 1
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-6347
Mailing Address - Country:US
Mailing Address - Phone:662-470-4187
Mailing Address - Fax:662-391-4236
Practice Address - Street 1:5699 GETWELL RD
Practice Address - Street 2:BUILDING H, SUITE 1
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-6347
Practice Address - Country:US
Practice Address - Phone:662-470-4187
Practice Address - Fax:662-391-4236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-02
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA2851231H00000X
261QH0700X
MSS3893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04852570Medicaid
MS04729074Medicaid