NPIMap

Organization Active NPI

Jane E. Perrin, PH.D.

Doing business as Psychological Services of the Triad

  • Psychologist
  • Greensboro, NC
National Provider Identifier
1205056918
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1102 Issued in NC
Legal business name
JANE E. PERRIN, PH.D.
Doing business as
Psychological Services of the Triad
Practice address
3608 W Friendly Ave
Suite #208
Greensboro, NC 27410-4865
Phone
(336) 299-1115
Fax
(336) 299-5559
NPI assigned
Apr 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jane E Perrin, PH.D.NPI 1114031499
Title
Owner
Phone
(336) 299-1115

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1102 NC Primary

Addresses

Primary practice location

3608 W Friendly Ave
Suite #208
Greensboro, NC 27410-4865

Mailing address

3608 W Friendly Ave
Suite #208
Greensboro, NC 27410-4865
Phone (336) 299-1115

Other identifiers 1

IdentifierTypeStateIssuer
04388OtherNCBLUE CROSS BLUE SHIELD

Other names 1

  • Psychological Services of the Triad Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205056918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3608 W FRIENDLY AVE",
            "address_2": "SUITE #208",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104865",
            "telephone_number": "336-299-1115",
            "fax_number": "336-299-5559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3608 W FRIENDLY AVE",
            "address_2": "SUITE #208",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274104865",
            "telephone_number": "336-299-1115",
            "fax_number": "336-299-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANE E. PERRIN, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PERRIN",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-299-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "1102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04388",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychological Services of the Triad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.