Southern, John Stephen
Southern, John Stephen is an sole proprietor health care provider with primary practice located at 106 Sugaloch Cv , Jackson MS 39211-3435. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Southern, John Stephen can be contacted via phone (618) 762-0303.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 071009636 | Illinois |
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | T0188 | Mississippi |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0571 | Mississippi |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 08559 | Texas |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 003695 | Pennsylvania |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 30540 | California |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 071.009636 | Illinois |
Profile Details
| NPI number | 1396084786 |
|---|---|
| LBN Legal business name | Southern, John Stephen |
| Credentials | EDD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 2013 |
| Last updated | Apr 11th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396084786 | NPPES |
| Illinois | Other | 071.009636 | CLINICAL PSYCHOLOGIST LICENSE |
| Illinois | Other | 30540 | CLINICAL PSYCHOLOGIST LICENSE |
| Illinois | Other | 0571 | CLINICAL PSYCHOLOGIST LICENSE |
| Illinois | Other | 0571 | CLINICAL PSYCHOLOGIST LICENSE |
| Illinois | Other | PS-003695-L | CLINICAL PSYCHOLOGIST LICENSE |
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