New Life Psychology Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002875 Issued in GA

Legal business name

NEW LIFE PSYCHOLOGY SERVICES, LLC

Practice address

1805 Herrington Rd
Building 2
Lawrenceville, GA 30043-7987

Phone

(770) 962-1944

NPI assigned

Sep 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marnette Bender Grall, PH.D.

Title

Owner

Phone

(404) 518-1018

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1932394855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "BUILDING 2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437987",
            "telephone_number": "770-962-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HERRINGTON RD",
            "address_2": "BUILDING 2",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300437987",
            "telephone_number": "770-962-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE PSYCHOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "GRALL",
        "authorized_official_first_name": "MARNETTE",
        "authorized_official_middle_name": "BENDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-518-1018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.