Southern Counseling and Psychological Services LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1353 Issued in NM

Legal business name

SOUTHERN COUNSELING AND PSYCHOLOGICAL SERVICES LLC

Practice address

104 E Linda Vista Blvd Ste B
Roswell, NM 88201-6667

Phone

(575) 624-8889

NPI assigned

Jan 8, 2015

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Douglas Stephen Southern, PH.D.

Title

Psychologist/Owner

Phone

(575) 420-1853

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1841688272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3391",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882023391",
            "telephone_number": "575-624-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E LINDA VISTA BLVD STE B",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882016667",
            "telephone_number": "575-624-8889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N. Main Ste 610",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "NM",
            "postal_code": "882014729",
            "country_code": "US",
            "telephone_number": "575-420-1853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN COUNSELING AND PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "SOUTHERN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "575-420-1853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "1353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10180087",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lorenza Solis, M.S. CF-SLP
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• Southern New Mexico Medical Association, PA
• Tina J Southward, PAC
• Southwest Ambulance of New Mexico
• Southwest C a R E Center
• Southwest Medical Associates, LLC

• Psychologist in Roswell, NM
• Providers in Roswell, NM by specialty
• Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.