Provider Demographics
NPI:1356691182
Name:ZEPHANIAH SERVICES PC
Entity type:Organization
Organization Name:ZEPHANIAH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:OZETTA
Authorized Official - Last Name:TROXLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:336-324-1610
Mailing Address - Street 1:PO BOX 41167
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27404-1167
Mailing Address - Country:US
Mailing Address - Phone:336-323-1385
Mailing Address - Fax:
Practice Address - Street 1:3409 W WENDOVER AVE STE E
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1579
Practice Address - Country:US
Practice Address - Phone:336-323-1385
Practice Address - Fax:888-959-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 251B00000X, 251S00000X
NC2790106H00000X, 101Y00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC986OtherMEDICARE PTAN
NC6008819Medicaid