Provider Demographics
NPI:1942426804
Name:SOUTHERN PSYCHOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:SOUTHERN PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ZWEIFLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:251-343-2022
Mailing Address - Street 1:6758 STONERIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3061
Mailing Address - Country:US
Mailing Address - Phone:251-776-5944
Mailing Address - Fax:
Practice Address - Street 1:273 AZALEA RD
Practice Address - Street 2:ONE OFFICE PARK, SUITE 305
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1970
Practice Address - Country:US
Practice Address - Phone:251-323-2022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL886103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty