Provider Demographics
NPI:1336217330
Name:THE PSYCHOLOGIST, LLC
Entity Type:Organization
Organization Name:THE PSYCHOLOGIST, LLC
Other - Org Name:HORIZONS UNLIMITED
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER'PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:BARTOW
Authorized Official - Last Name:RAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-547-3266
Mailing Address - Street 1:268 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-4133
Mailing Address - Country:US
Mailing Address - Phone:256-547-3266
Mailing Address - Fax:256-547-3267
Practice Address - Street 1:268 S 7TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-4133
Practice Address - Country:US
Practice Address - Phone:256-547-3266
Practice Address - Fax:256-547-3267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1294103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty