NPIMap

Organization Active NPI

Persoma P.C.

  • Mental Health Counselor
  • Monroeville, PA
National Provider Identifier
1790712156
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PERSOMA P.C.
Practice address
300 Oxford Dr Ste 110
Monroeville, PA 15146-2361
Phone
(412) 823-5155
Fax
(412) 823-8262
NPI assigned
Jun 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Authorized official

Name
Mr. Aaron Jennings, LCSWNPI 1386830529
Title
Owner
Phone
(412) 823-5155

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

300 Oxford Dr Ste 110
Monroeville, PA 15146-2361

Mailing address

300 Oxford Dr Ste 110
Monroeville, PA 15146-2361
Phone (412) 823-5155

Other identifiers 3

IdentifierTypeStateIssuer
1583512OtherPABC/BS
000630868OtherBC/BS
1583518OtherPABC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301001038 PA Part B Supplier - Clinic/Group Practice 9436046828 Receives reassigned benefits from 37 practitioners
Practice locations: Altoona, PA; Monroeville, PA; Pittsburgh, PA

National Provider Directory

National Provider Directory
Tax ID family
Persoma Counseling Associates2 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.

Locations

208 Frankstown Rd
Altoona, PA 16602

300 Oxford Dr
Ste 110
Monroeville, PA 15146
Phone 4128235155801

2540 Monroeville Blvd
Monroeville, PA 15146
Phone (412) 206-1411

61 McMurray Rd
Ste 404
Pittsburgh, PA 15241

200 High Tower Blvd
Pittsburgh, PA 15205

401 Shady Ave
Ste B207
Pittsburgh, PA 15206
Phone (240) 285-6507

Practitioners & affiliated clinicians

Practitioners 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671667200000",
    "number": "1790712156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 OXFORD DR STE 110",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462361",
            "telephone_number": "412-823-5155",
            "fax_number": "412-823-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 OXFORD DR STE 110",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462361",
            "telephone_number": "412-823-5155",
            "fax_number": "412-823-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSOMA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-823-5155",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1583512",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "000630868",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "1583518",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; 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.