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SOUTHEASTERN HEALTH SERVICES INC. NPI 1295955680


NPI Information

NPI: 1295955680
Provider Name: SOUTHEASTERN HEALTH SERVICES, INC.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Organization
Address:
1624 FREDERICA RD
SUITE 3
SAINT SIMONS ISLAND, GA
ZIP 31522
Phone: (912) 634-1677
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SOUTHEASTERN HEALTH SERVICES, INC. is a clinical neuropsychologist in Saint Simons Island, GA. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. SOUTHEASTERN HEALTH SERVICES, INC. NPI is 1295955680. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1624 FREDERICA RD
SUITE 3
SAINT SIMONS ISLAND, GA
ZIP 31522-506
Phone: (912) 634-1677
Fax: (912) 634-1677

The provider's authorized official is Deanna Jane Hart .
The authorized official title is President and has the following contact phone number (904) 280-4491.

The enumeration date for this NPI number is 4/26/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103G00000XClinical NeuropsychologistPSY001838GEORGIAYes
2103T00000XPsychologistPSY001838GEORGIAX
3103TA0700XPsychologistAdult Development & AgingPSY001838GEORGIAX
4103TB0200XPsychologistCognitive & BehavioralPSY001838GEORGIAX
5103TC0700XPsychologistClinicalPSY001838GEORGIAX
6103TC1900XPsychologistCounselingPSY001838GEORGIAX
7103TH0004XPsychologistHealthPSY001838GEORGIAX
8103TH0100XPsychologistHealth ServicePSY001838GEORGIAX
9103TP2701XPsychologistGroup PsychotherapyPSY001838GEORGIAX
10103TR0400XPsychologistRehabilitationPSY001838GEORGIAX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.