MEDICARE: ZEPHANIAH SERVICES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	106H00000X	Marriage & Family Therapist	2790	NC
3	251B00000X	Case Management Agency
4	101Y00000X	Counselor	2790	NC
5	103T00000X	Psychologist	2790	NC
6	251S00000X	Community/Behavioral Health Agency

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C986	OTHER	NC	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356691182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEPHANIAH SERVICES PC

Provider Business Mailing Address
First Line	:	PO BOX 41167
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27404-1167
Country	:	US
Telephone Number	:	336-323-1385
Fax Number	:

Provider Business Practice Location Address
First Line	:	3409 W WENDOVER AVE STE E
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-1579
Country	:	US
Telephone Number	:	336-323-1385
Fax Number	:	888-959-2812

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

Provider Enumeration Date	:	09/19/2012
Last Update Date	:	06/22/2021

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Directions to “ZEPHANIAH SERVICES PC ” Practice Location

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