Personalized Therapy, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PERSONALIZED THERAPY, INC.

Practice address

1226 Mann Dr
Suite 100
Matthews, NC 28105-5532

Phone

(704) 846-1625

Fax

(704) 846-1635

NPI assigned

Feb 11, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Christie Sayers Martin

Title

Qa/Qi Director

Phone

(252) 353-4968

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Personalized Therapy Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Personalized Therapy, Inc.

  • Community/Behavioral Health Agency
  • Greenville, NC
  • NPI 1699078311
  NPD tax ID

Locations

Practitioners 1

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

• Lauren Mason Thorn, MSW, LCSW

  • Clinical Social Worker
  • Greenville, NC
  • NPI 1831321496
  NPD (past)

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251936000000",
    "number": "1316125545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 CONFERENCE DR",
            "address_2": "SUITE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585971",
            "telephone_number": "252-353-4968",
            "fax_number": "252-353-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 MANN DR",
            "address_2": "SUITE 100",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055532",
            "telephone_number": "704-846-1625",
            "fax_number": "704-846-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2009-09-03",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_middle_name": "SAYERS",
        "authorized_official_title_or_position": "QA/QI DIRECTOR",
        "authorized_official_telephone_number": "252-353-4968",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301790B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301790",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301790G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte Smith Pering, MA, LCMHCA
• Kimberlee Kruger Perras, MS, RN, FNP-C
• Kelsey Michelle Perry, DMD
• Tyrah Perry
• Diondre Person
• Melissa Petcu
• Brenda Wright Peters, MS, CCC-SLP
• Luke Tyler Peterson, M.D.
• Alyssa Petruzzello
• Mark M Petryna, DDS

• Community/Behavioral Health Agency in Matthews, NC
• Providers in Matthews, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; 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.