Provider Demographics
NPI:1104400068
Name:STRICKLAND, HARLEY
Entity Type:Individual
Prefix:
First Name:HARLEY
Middle Name:
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E US HIGHWAY 80
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:GA
Mailing Address - Zip Code:31302-9230
Mailing Address - Country:US
Mailing Address - Phone:912-312-3136
Mailing Address - Fax:
Practice Address - Street 1:301 E US HIGHWAY 80
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:GA
Practice Address - Zip Code:31302-9230
Practice Address - Country:US
Practice Address - Phone:912-412-7178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW008836104100000X
SC12618104100000X
GACSW0077561041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical