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CHILD NEUROBEHAVIORAL CENTER FOR HEALTH & WELLNESS PC NPI 1295898476


NPI Information

NPI: 1295898476
Provider Name: CHILD NEUROBEHAVIORAL CENTER FOR HEALTH & WELLNESS, PC

Former Legal Business Name: MARIA E GANGAROSA-EMERSON, PHD, PC

Classification: Psychologist - 103T00000X
Entity Type: Organization
Address:
302 BASTON RD
MARTINEZ, GA
ZIP 30907
Phone: (706) 447-8700
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CHILD NEUROBEHAVIORAL CENTER FOR HEALTH & WELLNESS, PC is a psychologist in Martinez, GA. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. CHILD NEUROBEHAVIORAL CENTER FOR HEALTH & WELLNESS, PC NPI is 1295898476. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Maria E Gangarosa-emerson, Phd, Pc.

The provider's business location address is:

302 BASTON RD
MARTINEZ, GA
ZIP 30907-906
Phone: (706) 447-8700
Fax: (706) 447-8701

The provider's authorized official is Maria E Gangarosa Emerson .
The authorized official title is Owner and has the following contact phone number (706) 447-8700.

The enumeration date for this NPI number is 12/18/2006 and was last updated on 4/3/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical Neuropsychologist2381GEORGIANo
2235Z00000XSpeech-Language PathologistNo
3101YM0800XCounselorMental HealthNo
4103T00000XPsychologist2381GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
152669312-001OTHERGEORGIABCBS
2=========OTHERGEORGIAGENERAL INS #
3000852277BMEDICAIDGEORGIA
468BBGJVMEDICARE ID-TYPE UNSPECIFIEDGEORGIA
5=========001OTHERGEORGIATRICARE
6Q22624MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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