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General NPI Number Information
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NPI Number | 1396100863
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Entity Type | Organization
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Legal Business Name | NEW ALBANY PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 571 HIGH ST STE 12
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City | WORTHINGTON
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State | OH
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Zip | 43085-4132
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Country | US
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Telephone | 413-218-1105
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Fax | 614-591-0710
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Provider Business Mailing Address
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Address Line | 571 HIGH ST STE 12
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City | WORTHINGTON
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State | OH
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Zip | 43085-4132
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Country | US
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Telephone | 413-218-1105
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Fax | 614-591-0710
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH DONALD MANGINE
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Credential | PH.D.
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Telephone | 413-218-1105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 7370
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License Number State | OH
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