NPIMap

Organization Active NPI

Personalized Therapy, LLC

  • Occupational Therapist
  • California, MD
National Provider Identifier
1699711135
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
PERSONALIZED THERAPY, LLC
Practice address
22593 Three Notch Rd
California, MD 20619
Phone
(301) 862-2505
Fax
(301) 862-2548
NPI assigned
Jun 22, 2006
Last updated
Aug 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Authorized official

Name
Miss Melanie A Lohwater, OTR/LNPI 1881620086
Title
Otr/L
Phone
(301) 904-2351

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU
Psychologist 103T00000X NU
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU Primary
Speech-Language Pathologist 235Z00000X NU
Behavior Analyst 103K00000X NU
Assistant Behavior Analyst 106E00000X NU

Addresses

Primary practice location

22593 Three Notch Rd
California, MD 20619

Mailing address

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

Other practice location 1

1005 Prince Frederick Blvd
Prince Frederick, MD 20678-3194
Phone (301) 862-2505

Other practice location 2

3261 Old Washington Rd Ste 1010
Waldorf, MD 20602-3228
Phone (301) 862-2505

Other practice location 3

20410 Point Lookout Rd
Great Mills, MD 20634-3328
Phone (301) 862-2505

Other practice location 4

20945 Great Mills Rd
Lexington Park, MD 20653-4369
Phone (301) 862-2505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060711000379 MD Part B Supplier - Clinic/Group Practice 3072526235 Receives reassigned benefits from 11 practitioners
Practice locations: Waldorf, MD; California, MD
O20210406000362 MD DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational Therapist 3072526235 Practice locations: California, MD

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

20410 Point Lookout Rd
Great Mills, MD 20634
Phone (301) 862-2505

20945 Great Mills Rd
Lexington Park, MD 20653
Phone (301) 862-2505

20945 Great Mills Rd
Ste 201
Lexington Park, MD 20653
Phone (240) 298-0222

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

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

Practitioners & affiliated clinicians

Practitioners 12

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": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535587200000",
    "number": "1699711135",
    "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": "22593 THREE NOTCH RD",
            "city": "CALIFORNIA",
            "state": "MD",
            "postal_code": "20619",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Prince Frederick Blvd",
            "address_purpose": "LOCATION",
            "city": "Prince Frederick",
            "state": "MD",
            "postal_code": "206783194",
            "country_code": "US",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3261 Old Washington Rd Ste 1010",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206023228",
            "country_code": "US",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20410 Point Lookout Rd",
            "address_purpose": "LOCATION",
            "city": "Great Mills",
            "state": "MD",
            "postal_code": "206343328",
            "country_code": "US",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20945 Great Mills Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington Park",
            "state": "MD",
            "postal_code": "206534369",
            "country_code": "US",
            "telephone_number": "301-862-2505",
            "fax_number": "301-862-2548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERSONALIZED THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2018-08-30",
        "status": "A",
        "authorized_official_last_name": "LOHWATER",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OTR/L",
        "authorized_official_telephone_number": "301-904-2351",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in California, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.