Marnette Ann Bender, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002875 Issued in GA

Practice address

118 E Trinity PL
Suite 100
Decatur, GA 30030-3302

Phone

(404) 518-1018

Fax

(770) 962-1886

NPI assigned

Jun 22, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Marnette Bender Grall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1962408294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 E TRINITY PL",
            "address_2": "SUITE 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "404-518-1018",
            "fax_number": "770-962-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E TRINITY PL",
            "address_2": "SUITE 100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303302",
            "telephone_number": "404-518-1018",
            "fax_number": "770-962-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDER",
        "first_name": "MARNETTE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-22",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARNETTE",
            "last_name": "GRALL",
            "middle_name": "BENDER",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2011; 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.