Provider Demographics
NPI:1477249613
Name:PSYCH THERAPY LLC
Entity Type:Organization
Organization Name:PSYCH THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARFELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:229-300-4524
Mailing Address - Street 1:204 SANSBURY TRL
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-3142
Mailing Address - Country:US
Mailing Address - Phone:229-300-4524
Mailing Address - Fax:
Practice Address - Street 1:204 SANSBURY TRL
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-3142
Practice Address - Country:US
Practice Address - Phone:478-257-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty