Dr John Stephen Southern, EDD is a
Counselor - Professional based in Jackson, Mississippi. Dr John Stephen Southern is licensed to practice in Mississippi (license number 0571) and his current practice location is
106 Sugaloch Cv, Jackson, Mississippi. He can be reached at his office (for appointments etc.) via phone at
(618) 762-0303.
NPI number for Dr John Stephen Southern is 1396084786 and his current mailing address is 106 Sugaloch Cv, Jackson, Mississippi. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1396084786.
Healthcare Provider's Profile
| Full Name | Dr John Stephen Southern |
|---|
| Gender | Male |
|---|
| Speciality | Counselor - Professional |
|---|
| Location | 106 Sugaloch Cv, Jackson, Mississippi |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1396084786
- Provider Enumeration Date: 02/06/2013
- Last Update Date: 04/11/2019
Medical Identifiers
Medical identifiers for Dr John Stephen Southern such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396084786 | NPI | - | NPPES |
| 071.009636 | Other | IL | CLINICAL PSYCHOLOGIST LICENSE |
| 30540 | Other | CA | PSYCHOLOGIST LICENSE |
| 0571 | Other | TX | PROFESSIONAL COUNSELOR LICENSE |
| 0571 | Other | MS | PROFESSIONAL COUNSELOR LICENSE |
| PS-003695-L | Other | PA | PSYCHOLOGIST LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | 071009636 (Illinois) | Secondary |
| 106H00000X | Marriage & Family Therapist | T0188 (Mississippi) | Secondary |
| 101YP2500X | Counselor - Professional | 0571 (Mississippi) | Primary |
| 101YP2500X | Counselor - Professional | 08559 (Texas) | Secondary |
| 103T00000X | Psychologist | 003695 (Pennsylvania) | Secondary |
| 103T00000X | Psychologist | 30540 (California) | Secondary |
| 103T00000X | Psychologist | 071.009636 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr John Stephen Southern is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr John Stephen Southern, EDD
106 Sugaloch Cv,
Jackson, MS 39211-3435
Ph: (618) 762-0303 | Dr John Stephen Southern, EDD
106 Sugaloch Cv,
Jackson, MS 39211-3435
Ph: (618) 762-0303 |
Reviews and Comments