Provider Demographics
NPI:1760711535
Name:MARBURY & ASSOCIATES LLC
Entity Type:Organization
Organization Name:MARBURY & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JA'NITTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARBURY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PCC-S
Authorized Official - Phone:216-371-3420
Mailing Address - Street 1:5589 DUNHAM RD STE 107
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-3657
Mailing Address - Country:US
Mailing Address - Phone:216-371-3420
Mailing Address - Fax:216-371-3430
Practice Address - Street 1:5589 DUNHAM RD STE 107
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-3657
Practice Address - Country:US
Practice Address - Phone:216-371-3420
Practice Address - Fax:216-371-3430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171W00000X
OHE0500062-SUPV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty