Holistic Therapy by Design

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC00031600 Issued in NJ

Legal business name

HOLISTIC THERAPY BY DESIGN

Practice address

30 Moran St
Newton, NJ 07860-1832

Phone

(973) 963-1038

NPI assigned

Feb 3, 2016

Organization subpart

No

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

Authorized official

Name

Lori S Petry, LCSWNPI 1073663803

Title

Owner

Phone

(973) 963-1038

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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

• Lori Petry, MSW

  • Clinical Social Worker
  • Newton, NJ
  • NPI 1073663803
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1154789303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 345",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078600345",
            "telephone_number": "973-963-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MORAN ST",
            "city": "NEWTON",
            "state": "NJ",
            "postal_code": "078601832",
            "telephone_number": "973-963-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC THERAPY BY DESIGN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "PETRY",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-963-1038",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00031600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Newton, NJ
• Providers in Newton, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.