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General NPI Number Information
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NPI Number | 1386059251
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Entity Type | Organization
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Legal Business Name | NEUROBEHAVIORAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 207 HUDSON TRCE
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City | AUGUSTA
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State | GA
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Zip | 30907-2010
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Country | US
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Telephone | 706-823-5250
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Fax | 706-823-5266
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Provider Business Mailing Address
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Address Line | 207 HUDSON TRCE
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City | AUGUSTA
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State | GA
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Zip | 30907-2010
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Country | US
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Telephone | 706-823-5250
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Fax | 706-823-5266
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Authorized Official
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Title or Position | EXEC CLINICAL DIRECTOR
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Name | MR. JEREMY B HERTZA
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Credential | PSYD
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Telephone | 706-823-5266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APC004405
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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