Provider Demographics
NPI:1942742531
Name:METTA PSYCHOLOGY GROUP, LLC
Entity Type:Organization
Organization Name:METTA PSYCHOLOGY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-946-1353
Mailing Address - Street 1:1560 FISHINGER RD
Mailing Address - Street 2:STE 260
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-2108
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1560 FISHINGER RD
Practice Address - Street 2:STE 260
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2108
Practice Address - Country:US
Practice Address - Phone:614-705-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6615103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty