Psychological Consultants Of Marietta, Pc

LBN: Psychological Consultants Of Marietta, Pc
Psychological Consultants Of Marietta, Pc is an health care organization with primary practice located at 600 Kennesaw Ave Nw Suite 300, Marietta GA 30060-6988. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Psychological Consultants Of Marietta, Pc can be contacted via phone (770) 420-9448, or through Roland, Mark Manfred via phone (770) 420-9448.

Contact Information

Primary practice address
600 Kennesaw Ave Nw Suite 300 Marietta GA 30060-6988
Phone: (770) 420-9448
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Roland, Mark Manfred PH.D.
Phone: (770) 420-9448

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1872 Georgia
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 897 Georgia

Profile Details

NPI number 1093802233
LBN Legal business name Psychological Consultants Of Marietta, Pc
DBA Doing business as
Authorized official Roland, Mark Manfred PH.D.
Entity Organization
Organization subpart 1 No
Enumeration date Oct 9th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093802233 NPPES
Georgia MEDICAID 00661691A

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