Provider Demographics
NPI:1346436763
Name:STRICKLAND, SUSAN J (PHD, LCSW, MT-BC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:J
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:PHD, LCSW, MT-BC
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:J
Other - Last Name:COULTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 20162
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32316-0162
Mailing Address - Country:US
Mailing Address - Phone:850-212-0702
Mailing Address - Fax:850-386-4583
Practice Address - Street 1:2014 DELTA BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4853
Practice Address - Country:US
Practice Address - Phone:850-212-0702
Practice Address - Fax:850-386-4583
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW85611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ139HOtherBLUE CROSS/BLUE SHIELD
FL7186922OtherAETNA
FLZ139HOtherBLUE CROSS/BLUE SHIELD
FLAH195ZMedicare UPIN