Provider Demographics
NPI:1174687172
Name:STRANGSTALIEN, MIKE ALLEN (MA MFT NCC LPC)
Entity Type:Individual
Prefix:MR
First Name:MIKE
Middle Name:ALLEN
Last Name:STRANGSTALIEN
Suffix:
Gender:M
Credentials:MA MFT NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 E LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85721-0095
Mailing Address - Country:US
Mailing Address - Phone:520-621-3334
Mailing Address - Fax:520-626-6105
Practice Address - Street 1:1224 E LOWELL ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-0095
Practice Address - Country:US
Practice Address - Phone:520-621-3334
Practice Address - Fax:520-626-6105
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-08-21
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-08-21
Provider Licenses
StateLicense IDTaxonomies
AZLPC10155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional