Provider Demographics
NPI:1073646964
Name:STRANO, JOSEPH D (PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:D
Last Name:STRANO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WHITES PL
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-1860
Mailing Address - Country:US
Mailing Address - Phone:309-530-3979
Mailing Address - Fax:
Practice Address - Street 1:2 WHITES PL
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-1860
Practice Address - Country:US
Practice Address - Phone:309-530-3979
Practice Address - Fax:309-530-3979
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2011-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166-000170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist