NPIMap

Organization Active NPI

Persimmon Therapy and Wellness, LLC

  • Marriage & Family Therapist
  • Mountain BRK, AL
National Provider Identifier
1932832318
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
PERSIMMON THERAPY AND WELLNESS, LLC
Practice address
500 Office Park Dr Ste 200
Mountain BRK, AL 35223-2441
Phone
(205) 617-5612
NPI assigned
Jul 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Mr. Roy Martin, LMFTNPI 1326703802
Title
Therapist
Phone
(205) 617-5612

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
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

500 Office Park Dr Ste 200
Mountain BRK, AL 35223-2441

Mailing address

500 Office Park Dr Ste 200
Mountain BRK, AL 35223-2441
Phone (205) 617-5612

National Provider Directory

National Provider Directory

Locations

500 Office Park Dr
Ste 200
Mountain Brk, AL 35223
Phone (205) 617-5612

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1932832318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 OFFICE PARK DR STE 200",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232441",
            "telephone_number": "205-617-5612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OFFICE PARK DR STE 200",
            "city": "MOUNTAIN BRK",
            "state": "AL",
            "postal_code": "352232441",
            "telephone_number": "205-617-5612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSIMMON THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "205-617-5612",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain BRK, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.