Organization
SOUTHERN HILLS COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD KENT WHITAKER JR. PH. D. (ASSOCIATE DIRECTOR/CFO)
(812) 482-3020
Entity
Organization
Contact information
Practice address
480 EVERSMAN DR, JASPER, IN 47546-3548
(812) 482-3020
(812) 482-6409
Mailing address
PO BOX 769, JASPER, IN 47547-0769
(812) 482-3020
(812) 482-6409
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100108710
—
IN
Enumeration date
10/20/2005
Last updated
10/30/2013
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