Provider Demographics
NPI:1083270516
Name:JNB PSYCHOLOGY GS LLC
Entity Type:Organization
Organization Name:JNB PSYCHOLOGY GS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIANCHINI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:504-780-1702
Mailing Address - Street 1:2901 N I 10 SERVICE RD E STE 300
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6137
Mailing Address - Country:US
Mailing Address - Phone:504-301-7352
Mailing Address - Fax:
Practice Address - Street 1:6555 PERKINS RD STE 500
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4278
Practice Address - Country:US
Practice Address - Phone:504-780-1702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty