Individual
DR. JOHN STEPHEN SOUTHERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD
Contact information
Practice address
106 SUGALOCH CV, JACKSON, MS 39211-3435
(618) 762-0303
Mailing address
106 SUGALOCH CV, JACKSON, MS 39211-3435
(618) 762-0303
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0571
MS
101YP2500X
Professional Counselor
08559
TX
103T00000X
Psychologist
003695
PA
103T00000X
Psychologist
071.009636
IL
103T00000X
Psychologist
071009636
IL
103T00000X
Psychologist
30540
CA
106H00000X
Marriage & Family Therapist
T0188
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0571
PROFESSIONAL COUNSELOR LICENSE
MS
01
—
0571
PROFESSIONAL COUNSELOR LICENSE
TX
01
—
071.009636
CLINICAL PSYCHOLOGIST LICENSE
IL
01
—
30540
PSYCHOLOGIST LICENSE
CA
01
—
PS-003695-L
PSYCHOLOGIST LICENSE
PA
Enumeration date
02/06/2013
Last updated
04/11/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us