Healthcare Provider Details

I. General information

NPI: 1578093712
Provider Name (Legal Business Name): SOUTHERN COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E 14TH ST
ALMA GA
31510-2901
US

IV. Provider business mailing address

105 E 14TH ST
ALMA GA
31510-2901
US

V. Phone/Fax

Practice location:
  • Phone: 912-347-8591
  • Fax:
Mailing address:
  • Phone: 912-347-8591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLPC0082
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC0082
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number033875
License Number StateGA

VIII. Authorized Official

Name: DR. TIMOTHY CHARLES HUTCHINSON
Title or Position: OWNER
Credential: PHD,LPC
Phone: 912-347-8591