Provider Demographics
NPI:1093149866
Name:STRUNK, STEPHEN VICTOR (LPC, CSOTP)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:VICTOR
Last Name:STRUNK
Suffix:
Gender:M
Credentials:LPC, CSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 BEECHWOOD POINT CT
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-2535
Mailing Address - Country:US
Mailing Address - Phone:804-647-3929
Mailing Address - Fax:
Practice Address - Street 1:6504 WOODLAKE VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-2200
Practice Address - Country:US
Practice Address - Phone:804-647-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001955101YP2500X
VA0812000038103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic