| Zephaniah Services Pc | |
|
3409 W Wendover Ave Ste E Greensboro NC 27407-1579 | |
| (336) 323-1385 | |
| (888) 959-2812 |
| Full Name | Zephaniah Services Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3409 W Wendover Ave Ste E, Greensboro, North Carolina |
| Authorized Official Name and Position | Susie Ozetta Troxler (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 3363241610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zephaniah Services Pc Po Box 41167 Greensboro NC 27404-1167 Ph: (336) 323-1385 | Zephaniah Services Pc 3409 W Wendover Ave Ste E Greensboro NC 27407-1579 Ph: (336) 323-1385 |
| NPI Number | 1356691182 |
|---|---|
| Provider Enumeration Date | 09/19/2012 |
| Last Update Date | 06/22/2021 |
| Certification Date | 06/22/2021 |
| Medicare PECOS PAC ID | 0345477741 |
|---|---|
| Medicare Enrollment ID | O20131210001170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356691182 | NPI | - | NPPES |
| C986 | Other | NC | MEDICARE PTAN |
| 6008819 | Medicaid | NC |
| Provider Name | Susie O Troxler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184627614 PECOS PAC ID: 7810932407 Enrollment ID: I20050623000810 |
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