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Staff Submission

Staff Submission Form

Use the form below to submit a new Staff member for the online directory. All submissions will be reviewed before publication.

Staff Submission

Create a new Staff post

First Name*
Last Name*
Job Title*
Program Facilitator
Upload Your Photo
Staff Type*
NPI Number
Please select the setting in which you provide services
- Amputee
- Brain Injury
- Home Care
- Inpatient
- Neurological
- Orthopedic
- Outpatient
- Outpatient Physician
- Schools
- Spinal Cord
- Stroke
Select the type of patients you treat
- Adult
- Pediatric
Services
- Adaptive Recreation
- Adult ADD/ADHD Therapy
- Amputation Rehabilitation Center
- Amtryke Therapy
- Anodyne Therapy
- Aquatic Therapy
- Bioness H200 Wireless
- Bioness Integrated Therapy System
- Bioness L300
- Brain Injury Rehabilitation Center
- Constraint Induced Movement Therapy (CIMT)
- Driving Rehabilitation
- Dry Needling
- Graston Technique and IASTM
- Hand Therapy
- Home Care Joint Camp
- Incontinence Therapy
- Independence Way
- Inpatient General Services
- Interactive Metronome
- LiteGait
- Lymphedema Therapy
- Maya Massage Therapy for Women
- Men's Health
- Modified Barium Swallow
- Neurological Recovery Center
- Occupational Therapy
- Orthopedic Rehabilitation Center
- Orthotics & Prosthetics
- Parkinson’s Disease Rehabilitation
- Parkinson’s Support Group
- Patient Coaches
- Pediatric Aquatic Therapy
- Pediatric Feeding Therapy
- Pediatric Orthotics
- Pediatric OT
- Pediatric Physical Therapy
- Pediatric Speech Therapy
- Pediatric Therapy Equipment
- Pelvic Floor Therapy
- Physical Therapy
- Post Mastectomy Therapy
- Post-COVID Therapy
- Pre/Post Natal Therapy
- Sensory Integration
- Spasticity Management
- Speech Therapy
- Spinal Cord Injury Inpatient Rehabilitation Center
- Spine Therapy
- Sports Medicine
- Stroke Rehabilitation Center
- Vestibular Therapy
- Vision Therapy
- Wheelchair Evaluations
- Women's Health Rehabilitation
- Work Conditioning Program
- Wound Care
Locations
If you don't wish to associated with a location simply don't select one.
- Northeast Rehab Hospital at Southern NH Medical Center in Nashua
- Northeast Rehab Hospital in Manchester, NH
- Northeast Rehab Hospital in Portsmouth, NH
- Northeast Rehab Hospital in Salem, NH
- Ortho and Spine Physical Therapy Center in Methuen, MA – Pelham St
- Physical Therapy Center in Billerica, MA
- Physical Therapy Center in Chelmsford, MA
- Physical Therapy Center in Haverhill at Cedardale Health Club
- Physical Therapy Center in Haverhill, MA at Pentucket Medical Building
- Physical Therapy Center in Lawrence, MA - Amesbury St.
- Physical Therapy Center in Lawrence, MA - Riverwalk
- Physical Therapy Center in Lowell, MA - Bridge St.
- Physical Therapy Center in Lowell, MA - Community Health Center
- Physical Therapy Center in Lowell, MA - George St.
- Physical Therapy Center in Methuen, MA – 386 Merrimack St (Pediatric Clinic)
- Physical Therapy Center in Methuen, MA 380R Merrimack St (Adult Clinic)
- Physical Therapy Center in Newburyport, MA
- Physical Therapy Center in North Andover, MA - Sutton St.
- Physical Therapy Center in North Andover, MA - Turnpike Street
- Physical Therapy Center in Plaistow, NH
- Physical Therapy Center in Portsmouth, NH
- Physical Therapy Center in Salem, NH - Stiles Rd.
- Physical Therapy Center in Salem, NH – Butler St. (Adult Clinic)
- Physical Therapy Center in Salem, NH – Butler St. (Pediatric Clinic)
- Physical Therapy Center in Tewksbury, MA
- Physical Therapy Center in Windham, NH
School of Graduation
Graduating Year
Credentials
Please make only one selection and choose your highest level of certification.
Specialty Certifications
- ATC – Athletic Trainer, Certified
- CCI – Certified Clinical Instructor
- CCS – Cardiovascular and Pulmonary Certified Specialist
- CAPP-Pelvic – Certificate of Achievement in Pelvic Physical Therapy
- CCVT/CVT – Certified Clinical Vestibular Therapist/ Clinical Vestibular Therapist
- CFC – Cranio-mandibular Head, Neck, and Facial Pain
- CFMT – Certified Functional Manual Therapist
- CHT – Certified Hand Therapist
- CLT – Certified Lymphedema Therapist (Also known as CLT-LANA)
- COMT – Certified Orthopedic Manual Therapist
- CSCS – Certified Strength and Conditioning Specialist
- CWS® – Certified Wound Specialist
- FAAOMPT – Fellow of the American Academy of Orthopedic Manual Physical Therapists
- GCS – Geriatric Certified Specialist
- MLD – Manual Lymph Drainage
- NCS – Neurologic Certified Specialist
- OCS – Orthopedic Certified Specialist
- PCS – Pediatric Certified Specialist
- SCS – Sports Certified Specialist
- WCC® – Wound Care Certified
- WCS – Women’s Certified Specialist
- CEIS - Certified Early Intervention Specialist
- CBIS - Certified Brain Injury Specialist
- CSCS – Certified Strength and Conditioning Specialist
- NDT – Neuro-developmental Treatment Certified
- IOMT – Institute of Orthopaedic Manual therapy
- Yoga (YRT 200 and YRT 400, etc.)
- Any specific coaching certifications (USATF, USAT, PGA, etc.)
- Feeding
- ATP - Assistive Technology
- Other Certification
Other Certification
Residency
Internship
Fellowship
Board Certified
Academic Affiliation
Sports and Activity Interests
- Tennis
- Golf
- Skiing
- Lacrosse
- Swimming
- Volleyball
- Snowboarding
- Softball
- Cycling and Spinning
- Gymnastic
- Cheerleading
- Motocross
- Mixed Martial Arts
- Kayaking and Canoeing
- Weight Lifting and Strength Training
- Ice Skating
- Racquetball
- Dance
- Climbing
- Fishing
- Triathlon
- Hiking
- Cross Fit
- Yoga
- Pilates
- Water Sports
- Running
- Field Hockey
- Musician
- Football
- Other
Please add your "other" Sport or Activity
Terms and Conditions*
- I give Northeast Rehab permission to use the information I have provided to create a profile that will be posted on www.northeastrehab.com
Phone
This field is for validation purposes and should be left unchanged.

Northeast Rehabilitation Hospital