Provider Demographics
NPI:1114781234
Name:SEVERE, NZINGA
Entity Type:Individual
Prefix:
First Name:NZINGA
Middle Name:
Last Name:SEVERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 SEABREEZE CT
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-5572
Mailing Address - Country:US
Mailing Address - Phone:443-463-0640
Mailing Address - Fax:
Practice Address - Street 1:175 SEABREEZE CT
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-5572
Practice Address - Country:US
Practice Address - Phone:443-463-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)