Provider Demographics
NPI:1801370614
Name:STEVEN MARRINSON PHD PC
Entity Type:Organization
Organization Name:STEVEN MARRINSON PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARRINSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-849-9002
Mailing Address - Street 1:6 TALLULLAH CIRCLE
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602
Mailing Address - Country:US
Mailing Address - Phone:404-717-7041
Mailing Address - Fax:678-317-9051
Practice Address - Street 1:7170 E TIERRA BUENA LANE
Practice Address - Street 2:424
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254
Practice Address - Country:US
Practice Address - Phone:404-717-7041
Practice Address - Fax:678-317-9051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ097946Medicaid
AZ4744OtherLICENSE