Provider Demographics
NPI:1619002128
Name:NEWBRIDGE NW PSYCHOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:NEWBRIDGE NW PSYCHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-386-6222
Mailing Address - Street 1:108 FORREST AVE
Mailing Address - Street 2:P.O. BOX 3747
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3614
Mailing Address - Country:US
Mailing Address - Phone:770-386-6222
Mailing Address - Fax:770-386-9801
Practice Address - Street 1:108 FORREST AVE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3614
Practice Address - Country:US
Practice Address - Phone:770-386-6222
Practice Address - Fax:770-386-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty