Provider Demographics
NPI:1326101650
Name:MARRINSON, STEVEN ANDREW (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANDREW
Last Name:MARRINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 TALLULLAH CIR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-7242
Mailing Address - Country:US
Mailing Address - Phone:404-717-7041
Mailing Address - Fax:678-317-9051
Practice Address - Street 1:7170 E TIERRA BUENA LN APT 424
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3152
Practice Address - Country:US
Practice Address - Phone:404-717-7041
Practice Address - Fax:678-317-9051
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000556103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA227511300DOtherOWCP
GA680014338OtherRAILROAD MEDICARE
GA00160223CMedicaid