Healthcare Provider Details

I. General information

NPI: 1356691182
Provider Name (Legal Business Name): ZEPHANIAH SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 W WENDOVER AVE STE E
GREENSBORO NC
27407-1579
US

IV. Provider business mailing address

PO BOX 41167
GREENSBORO NC
27404-1167
US

V. Phone/Fax

Practice location:
  • Phone: 336-323-1385
  • Fax: 888-959-2812
Mailing address:
  • Phone: 336-323-1385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2790
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2790
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2790
License Number StateNC
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SUSIE OZETTA TROXLER
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: PHD
Phone: 336-324-1610