| Southeastern Psychological And Counseling Services, Llc | |
|
256 Honeysuckle Rd Suite 14 Dothan AL 36305-1157 | |
| (334) 794-5467 | |
| (334) 677-1051 |
| Full Name | Southeastern Psychological And Counseling Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 256 Honeysuckle Rd, Dothan, Alabama |
| Authorized Official Name and Position | J. Walter Jacobs (PRESIDENT) |
| Authorized Official Contact | 3347945467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeastern Psychological And Counseling Services, Llc 256 Honeysuckle Rd Suite 14 Dothan AL 36305-1157 Ph: (334) 794-5467 | Southeastern Psychological And Counseling Services, Llc 256 Honeysuckle Rd Suite 14 Dothan AL 36305-1157 Ph: (334) 794-5467 |
| NPI Number | 1689790495 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9234203639 |
|---|---|
| Medicare Enrollment ID | O20080804000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689790495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1377 (Alabama) | Primary |
| 103T00000X | Psychologist | 325 (Alabama) | Primary |
| Provider Name | Ann L Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588767768 PECOS PAC ID: 2860380433 Enrollment ID: I20080804000073 |
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