Individual provider Active NPI

Stephanie Anne Northington, PH.D.

  • Psychologist
  • Augusta, GA
National Provider Identifier
1457632150
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
003548 Issued in GA
Practice address
1265 Interstate Pkwy
Augusta, GA 30909-6481
Phone
(706) 849-3386
NPI assigned
Sep 8, 2011
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 12273
Psychologist 103T00000X 003548 GA Primary

Addresses

Primary practice location

1265 Interstate Pkwy
Augusta, GA 30909-6481

Mailing address

3633 Wheeler Rd Ste 320
Augusta, GA 30909-6552
Phone (706) 842-3279

Other practice location 1

3633 Wheeler Rd Ste 320
Augusta, GA 30909-6552
Phone (706) 842-3279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111201000401 GA Practitioner - Clinical Psychologist 8123292190 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
003548GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Psychology Solutions LLC Psychologist CurrentSince Sep 21, 2023 Accepting new patients
Neighborhood Improvement Project, Inc CurrentSince Nov 1, 2023 Accepting new patients
Neighborhood Improvement Project Inc CurrentSince Nov 1, 2023 Accepting new patients
Mindful Mentality, LLC Behavior Analyst CurrentSince Sep 1, 2023 Accepting new patients
New Mercy Behavioral Health LLC PastSince Jun 1, 2020 Accepting new patients

Locations

1265 Interstate Pkwy
Augusta, GA 30909
Phone (706) 204-1366

1265 Interstate Pkwy
#B
Augusta, GA 30909
Phone (706) 204-1366

2467 Golden Camp Rd
Augusta, GA 30906
Phone (706) 922-0682

3633 Wheeler Rd
Ste 320
Augusta, GA 30909
Phone (706) 691-4729

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1457632150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 WHEELER RD STE 320",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096552",
            "telephone_number": "706-842-3279",
            "fax_number": "706-842-3272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 INTERSTATE PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096481",
            "telephone_number": "706-849-3386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3633 Wheeler Rd Ste 320",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096552",
            "country_code": "US",
            "telephone_number": "706-842-3279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORTHINGTON",
        "first_name": "STEPHANIE",
        "middle_name": "ANNE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "12273",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "003548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.