NPIMap

Organization Active NPI

Personalized Therapy, LLC

  • Behavior Analyst
  • Prince Frederick, MD
National Provider Identifier
1063980290
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
PERSONALIZED THERAPY, LLC
Practice address
1005 Prince Frederick Blvd Ste 102
Prince Frederick, MD 20678-3195
Phone
(301) 862-2505
Fax
(301) 862-2548
NPI assigned
Nov 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Authorized official

Name
Melanie Ann LohwaterNPI 1881620086
Title
Owner
Phone
(301) 862-2505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X

Addresses

Primary practice location

1005 Prince Frederick Blvd Ste 102
Prince Frederick, MD 20678-3195

Mailing address

22593 Three Notch Rd
California, MD 20619-3054
Phone (301) 862-2505

National Provider Directory

National Provider Directory
Tax ID family
Personalized Therapy LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1005 Prince Frederick Blvd
Ste 102
Prince Frederick, MD 20678
Phone (301) 862-2505

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541462400000",
    "number": "1063980290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22593 THREE NOTCH RD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "206193054",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 PRINCE FREDERICK BLVD STE 102",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783195",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A",
        "authorized_official_last_name": "LOHWATER",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-862-2505"
    },
    "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": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; 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.